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PubMed2005

[Large-scale genotyping in research into autism spectrum disorders and attention deficit hyperactivity disorder].

INTRODUCTION AND DEVELOPMENT: Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are two neuropsychiatric disorders beginning in childhood that present a high degree of familial aggregation. ASD is characterised by social interaction and communication disorders, whereas patients with ADHD display persistent inattention and/or hyperactive-impulsive behaviour. With the exception of a few cases of autism in which cytogenetic anomalies or mutations have been reported in specific genes, the aetiology of these diseases remains unknown. This is a group of multifactorial diseases with several genes having a lesser effect and there is also an environmental component. Genetic linkage studies have pointed to about 20 chromosomal regions that could well contain genes that grant susceptibility to autism, to ADHD or to both disorders. The challenge to researchers lies in the clinical characterisation, recruitment of patients with ASD and ADHD, gene dosage quantification studies, comparative genomic methylation and hybridisation in order to identify chromosomal rearrangements in patients with autism and severe mental retardation. CONCLUSIONS: Genotyping large SNP-type collections that are potentially functional in genes that are candidates for these disorders, based on pharmacological, biochemical and neuropathological data together with that coming from animal models and linkage studies in a wide collection of samples from patients and controls, will enable us to identify the genetic components of these pathologies and to define their biological foundations.

Attention Deficit Disorder with Hyperactivity↗

PubMed1999

Alcohol responsiveness, hyperreactivity, and motor restlessness in an animal model for attention-deficit hyperactivity disorder.

RATIONALE: Attention-deficit hyperactivity disorder and related pervasive developmental disorders constitute risk factors for adult alcohol abuse and antisocial behaviours, including violent offending. OBJECTIVES: The present study assessed alcohol responsiveness and hyperemotionality in neonatally 6-OHDA-treated rats, which provides an animal model for attention-deficit hyperactivity disorder. METHOD: Male Wistar rats were given intracerebroventricular 6-OHDA (100 microg/5 microl) or vehicle (saline-ascorbic acid) on postnatal day 3. In adulthood, we measured motor activity, defensive behaviours and ethanol responsiveness. RESULTS: 6-OHDA resulted in depletions of brain catecholamine levels. The experimental animals were markedly hyperactive, showed increases in active defensive behaviours (fleeing) and decreases in passive defensive responses (freezing) in response to an sudden auditory signal. In tests for reactivity to the experimenter (i.e. defensiveness to innocuous stimuli), 6-OHDA rats were hyperreactive in comparison to controls. With regard to home cage 6% ethanol and water consumption, there were no differences between experimental and control rats. However, 6-OHDA rats displayed a remarkable resistance to the motor-impairing effect of alcohol (0.5-1.0 g/kg, IP). A similar hyposensitivity to the motor-suppressive effect of diazepam (5.0 mg/kg, IP) was also found. CONCLUSIONS: The present results show that adult rats exposed to 6-OHDA as neonates are motorically restless, unusually prone to respond defensively to innocuous stimuli, and considerably less sensitive to the intoxicating effects of ethanol and diazepam.

Alcohol Drinking↗

PubMed2006

[What is child attention deficit hyperactivity disorder?].

Prevalence of attention deficit hyperactivity disorder (ADHD) is around 5%. The main clinical criteria of ADHD are hyperactivity, impulsivity and attention deficit. Several clinical patterns are described. ADHD symptomatology change with age but always start before 7 years old. Comorbidity is frequent and it is important to distinguish ADHD and another differential diagnostic. Disorder mechanism is complex and associate several factors mainly neurobiologicals and genetics. For diagnostic, we use a clinical approach. Some questionnaires, cognitive and attentional tests can help for. It is important to take into account parent, child, caregiver and professor observations. Developmental evaluation is necessary for diagnostic and therapeutic strategy.

Attention Deficit Disorder with Hyperactivity↗

PubMed1998

The outcome of parent training using the behavior management flow chart with mothers and their children with oppositional defiant disorder and attention-deficit hyperactivity disorder.

The effects of parent training, using parameters established in the Behavior Management Flow Chart, on mother behavior and on the disruptive behavior of eight children who emitted behavior consistent with the diagnoses of both Oppositional Defiant Disorder and Attention-Deficit Hyperactivity Disorder were evaluated. There are important differences between the Behavior Management Flow Chart and well-known parent-training programs that are based on the Hanf model. Parent training was conducted within a multiple baseline design across children. Direct observation of mother and child behavior, phone interviews, and standardized rating scales showed that training improved parenting behavior, reduced maternal stress, and reduced oppositional child behavior. A 6-month follow-up revealed that parenting and child behavior remained stable. The results are comparable with prior research on behavioral parent training for families that have children with oppositional/hyperactive behavior.

Adult↗

PubMed2003

A placebo-controlled study of lofexidine in the treatment of children with tic disorders and attention deficit hyperactivity disorder.

This study evaluated the efficacy and safety of Lofexidine in treating children with tic disorders and attention deficit hyperactivity disorder (ADHD). Subjects from a specialty tic disorders clinic were randomly assigned to receive 8 weeks of treatment with lofexidine or placebo under double-blind conditions. Follow-up visits occurred every 2 weeks for safety monitoring and dose adjustment. Fourty-four medication-free subjects (41 boys and three girls; mean age of 10.4 years) with ADHD, combined type, and a tic disorder participated. After 8 weeks of treatment, lofexidine was associated with a mean improvement of 41% in the total score on the teacher-rated ADHD Rating Scale compared to 7% improvement for placebo. Eleven of 22 subjects who received lofexidine were blindly rated on the Clinical Global Scale-Improvement as either much improved or very much improved compared to none of 22 subjects who received placebo. The mean score on the parent-rated hyperactivity index improved by 29% in the lofexidine group and 18% in the placebo group, which was not a significant difference. On the Continuous Performance Test, commission errors decreased by 25% and omission errors by 20% in the lofexidine group, compared with increases of 33% in commission errors and of 36% in omission errors in the placebo group. Tic severity decreased by 27% in the lofexidine group, compared to 0% in the placebo group. One lofexidine subject with sedation withdrew at week 4. Lofexidine was associated with insignificant decreases in blood pressure and pulse. Lofexidine appears to be a safe and effective treatment for children with tic disorders and ADHD.

Adolescent↗

PubMed2001

A placebo-controlled study of guanfacine in the treatment of children with tic disorders and attention deficit hyperactivity disorder.

OBJECTIVE: This study evaluated the efficacy and safety of guanfacine in treating children with tic disorders and attention deficit hyperactivity disorder (ADHD). METHOD: Subjects from a specialty tic disorders clinic were randomly assigned to receive 8 weeks of treatment with guanfacine or placebo under double-blind conditions. Follow-up visits occurred every 2 weeks for safety monitoring and dose adjustment. RESULTS: Thirty-four medication-free subjects (31 boys and three girls with a mean age of 10.4 years) with ADHD, combined type, and a tic disorder participated. After 8 weeks of treatment, guanfacine was associated with a mean improvement of 37% in the total score on the teacher-rated ADHD Rating Scale, compared to 8% improvement for placebo. Nine of 17 subjects who received guanfacine were blindly rated on the Clinical Global Improvement scale as either much improved or very much improved, compared with none of 17 subjects who received placebo. The mean score on the parent-rated hyperactivity index improved by 27% in the guanfacine group and 21% in the placebo group, not a significant difference. On the Continuous Performance Test, commission errors decreased by 22% and omission errors by 17% in the guanfacine group, compared with increases of 29% in commission errors and of 31% in omission errors in the placebo group. Tic severity decreased by 31% in the guanfacine group, compared to 0% in the placebo group. One guanfacine subject with sedation withdrew at week 4. Guanfacine was associated with insignificant decreases in blood pressure and pulse. CONCLUSIONS: Guanfacine appears to be a safe and effective treatment for children with tic disorders and ADHD.

Adolescent↗

PubMed2001

[Transcranial magnetic stimulation in child and adolescent psychiatry: excitability of the motor system in tic disorders and/or attention deficit hyperactivity disorders].

Motor system excitability can be investigated in vivo by means of single and paired pulse transcranial magnetic stimulation (TMS). Whereas the cortical silent period reflects the general degree of inhibitory mechanisms mainly within the sensorimotor loop, intracortical excitability measures the focused degree of inhibitory and facilitatory mechanisms within the motor cortex. In child and adolescent psychiatric disorders with uncontrollable motor behavior such as tics in tic disorder or motoric hyperactivity in attention deficit hyperactivity disorder (ADHD), different dysfunctional patterns of motor system excitability could be demonstrated compared to age-matched healthy controls: (1) In tic disorder, a shortened cortical silent period was observed, providing evidence of deficient inhibitory mechanisms within the sensorimotor loop, probably primarily at the level of the basal ganglia. (2) In ADHD, a decreased intracortical inhibition was found, probably reflecting deficient inhibitory mechanisms within the motor cortex (but enhancement of intracortical inhibition after oral intake of 10 mg methylphenidate). In order to investigate neurophysiological aspects of comorbidity, (3) motor system excitability was also measured in children with combined ADHD and tic disorder. The findings of a reduced intracortical inhibition as well as a shortened cortical silent period in these comorbid children provide evidence of additive effects at the level of motor system excitability. These decreased inhibitory mechanisms within the entire sensorimotor loop and especially the motor cortex could be essential neurobiological substrates of the deficient inhibitory motor control and regulation, respectively, in tic disorder and ADHD.

Adolescent↗

PubMed2006

Autism and attention deficit hyperactivity disorder: assessing attention and response control with the integrated visual and auditory continuous performance test.

Symptoms of attention deficit hyperactivity disorder (ADHD) have been widely reported in children with autism spectrum disorder (ASD). The current study investigated attention and response control in children with ASD, ADHD, and typical development using the Integrated Visual and Auditory Continuous Performance Test. Results indicate that many children with ASD show significant deficits in visual and auditory attention and greater deficits in impulsivity than children with ADHD or typical development. These findings suggest that many of the children with ASD demonstrate significant ADHD-like deficits. These findings are discussed in the context of symptoms, subtypes, and comorbidity.

Analysis of Variance↗

PubMedDate not supplied

[The diagnostic evaluation and therapeutic basis of immediate release methylphenidate in attention deficit hyperactivity disorder].

INTRODUCTION: Attention deficit disorder with or without hyperactivity (ADHD) is characterised by the patients' inability to pay attention in non selective activities, hyperactivity that is difficult to inhibit, impulsiveness with failure to control their reactions and an unstable personality, which gives rise to difficulties in learning, work, leisure activities and in the social milieu, and may get worse in unstructured settings. There is a clear predominance in males and a 57% possibility of inheritance. The biochemical causes underlying ADHD are unknown, although it is currently accepted that dopamine and noradrenaline release is reduced because of the positive response to methylphenidate (MPH) and other stimulants. AIMS: The aim of this study was to evaluate the response to immediate release MPH by combining clinical data based on the DSM IV and brain mapping and quantitative electroencephalogram studies (qEEG). PATIENTS AND METHODS: We conducted a study of 170 otherwise pathology free children with a 5 to 1 predominance of males and an average age of 8 years old. Patients' records were examined and a hemogram and general biochemical analysis were carried out together with tests to determine thyroid hormone and cortisol levels, and BM CEEG. In addition, 46 children were submitted to a nocturnal polysomnogram (nPSG). RESULTS: A third of the children presented associated pathologies such as allergic rhinitis, asthma, allergies and dermatitis, with no differences between sexes. Paroxysmal discharges were revealed by the nPSG in 16.7% and there was a general agreement between answers provided by families and teachers. In the qEEG the most striking data was the theta/alpha quotient, which showed a medium degree of generalised dominance of the theta band (but no correlation with age) in 49.9% and it was mild in 5.9%. Following a year's treatment, there was an overall, not focal, improvement in activity, mild dominance rose to 58.2% and the others fell 2.4%. The other traces were unspecific. Clinical progression was good in 78.2% of cases, 19.5% of mild complications being resolved by lowering the drug dosage or by withdrawing it altogether. CONCLUSIONS: 1). ADHD is more likely to remain into adulthood and it has been associated to immunological disorders or epileptiform paroxysms, although only in a minority of cases. 2). The effect of MPH can be objectified by serial recordings of digitised cortical bioelectrical activity, with synchronised progression of the clinical response.

Adult↗

PubMed2001

Linkage study of the alpha2A adrenergic receptor in attention-deficit hyperactivity disorder families.

Attention-deficit hyperactivity disorder (ADHD) is a common childhood psychiatric disorder, characterized by marked and pervasive inattention, hyperactivity, and impulsiveness. An alteration in the expression or function of the adrenergic system has been suggested to be involved in ADHD based on animal models, pharmacological interventions, and the neural circuitry of attentional processes. The efficacy of clonidine in reducing disruptive behaviors in some children with ADHD argues for a causal role of the adrenergic system and more specifically for the alpha2A receptors as clonidine is an alpha2A agonist that inhibits release of noradrenaline into the synapse. In animal studies, alpha2A receptor agonists have also been shown to improve performance on working memory tasks under distracting conditions, indicating that these receptors function in the regulation of attention. We examined the possibility that the gene for the alpha2A adrenergic receptor (ADRA2A) is linked to ADHD by testing a polymorphism located in the promoter region of the ADRA2A gene in a sample of 94 nuclear families with an ADHD proband. We found no evidence for linkage of the ADRA2A gene with ADHD, using the transmission disequilibrium test in this set of families.

Adolescent↗

PubMedDate not supplied

Attention deficit hyperactivity disorder: an update.

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder, affecting 3% to 5% of school-aged children. Of the 3 subtypes--predominantly inattentive, predominantly hyperactive/impulsive, and a combined subtype--the latter is the most commonly represented group, accounting for 50% to 70% of all ADHD individuals. Stimulant medication is the cornerstone of management; however, stimulants with a short duration of action have been problematic for some patients. Recent technologic advances in delivery systems offer many patients the option of a once-daily dosage.

Age Distribution↗

PubMed2003

On-line story representation in boys with attention deficit hyperactivity disorder.

Children with attention deficit hyperactivity disorder (ADHD) face an increased risk of poor achievement in school. Thus, knowledge of the cognitive processing abilities of children with ADHD is critical to understanding and improving their academic performance. Although many studies have focused on the specific nature of the attention deficit experienced by children with ADHD, few have examined higher order cognitive processing such as comprehension of stories. The present study examined the processes of encoding story information, building a story representation, and modifying a story representation in boys with ADHD and nonreferred boys. Boys were asked to narrate a story from a picture book twice. Boys with ADHD showed deficits in representing goals and goal plans in their narrations, as compared to nonreferred boys. Boys with ADHD also committed more errors than nonreferred boys, but did correct certain types of errors on their second telling. Implications are discussed in terms of future research needed to identify the cognitive deficits that account for these narrative deficits.

Attention↗

PubMed2001

Time perception and reproduction in young adults with attention deficit hyperactivity disorder.

Adults with attention deficit hyperactivity disorder (ADHD; n = 104) were compared with a control group (n = 64) on time estimation and reproduction tasks. Results were unaffected by ADHD subtype or gender. The ADHD group provided larger time estimations than the control group, particularly at long intervals. This became nonsignificant after controlling for IQ. The ADHD group made shorter reproductions than did the control group (15- and 60-s intervals) and greater reproduction errors (12-, 45-, 60-s durations). These differences remained after controlling for IQ and comorbid oppositional defiant disorder, depression, and anxiety. Only the level of anxiety contributed to errors (at 12-s duration) beyond the level of ADHD. Results extended findings on time perception in ADHD children to adults and ruled out comorbidity as the basis of the errors.

Adult↗

PubMed2004

No evidence of sleep apnea in children with attention deficit hyperactivity disorder.

Children with attention deficit hyperactivity disorder (ADHD) may have a component of sleep apnea causing arousal and contributing to ADHD behavior during the day. Twenty non-ADHD children between 4 and 16 years of age were compared with 18 children with ADHD with use of nocturnal polysomnography (PSG) and psychometric tests. The psychometric testing confirmed that the control group were normal and that the ADHD children fulfilled the diagnostic criteria for ADHD. The PSG showed normal arousal indexes for the ADHD group (9.8 +/- 3.9/hr) and controls (10.2 +/- 3.1/hr), and normal apnea/hypnea indexes for the ADHD group (1.0 +/- 2.4/hr) and controls (0.6 +/- 0.9/hr). The sleep architecture was not significantly different between groups. There were no sleep abnormalities in the ADHD children that could be responsible for, or contributing to, the disorder.

Adolescent↗

PubMed2006

The effect of polyphenolic extract from pine bark, Pycnogenol on the level of glutathione in children suffering from attention deficit hyperactivity disorder (ADHD).

UNLABELLED: Attention deficit hyperactivity disorder (ADHD) belongs to the neurodevelopmental disorders characterized by impulsivity, distractibility and hyperactivity. In the pathogenesis of ADHD genetic and non-genetic factors play an important role. It is assumed that one of non-genetic factors should be oxidative stress. Pycnogenol, an extract from the pine bark, consists of bioflavonoids, catechins, procyanidins and phenolic acids. Pycnogenol acts as powerful antioxidant, chelating agent; it stimulates the activities of some enzymes, like SOD, eNOS, and exhibits other biological activities. AIM: The aim of this randomized, double-blind, placebo-controlled trial was to investigate the influence of administered Pycnogenol or placebo on the level of reduced (GSH) and oxidized (GSSG) glutathione in children suffering from ADHD and on total antioxidant status (TAS). This is the first investigation of the redox glutathione state in relation to ADHD. RESULTS: One month of Pycnogenol administration (1 mg/kg body weight/day) caused a significant decrease in GSSG and a highly significant increase in GSH levels as well as improvement of GSH/GSSG ratio in comparison to a group of patients taking a placebo. TAS in children with ADHD was decreased in comparison with reference values. Pycnogenol administration normalizes TAS of ADHD children.

Adolescent↗

PubMedDate not supplied

[The biopsychosocial characteristics of schoolchildren with attention deficit hyperactivity disorder indicators].

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is one of the most frequent disorders in childhood. According to the literature, ADHD is a syndrome produced by multiple causes that depend on genetic factors and environmental and social adversities. AIMS: Our aim was to describe the biopsychosocial characteristics of schoolchildren with ADHD indicators. PATIENTS AND METHODS: The sample used in our study consisted of 31 children (aged between 7 and 10 years) studying in the first and second course of primary education in state-run schools in Florianopolis (Santa Catarina, Brazil), who had ADHD indicators based on the Diagnostic and Statistic Manual of Mental Disorders (DSM-IV) and the EDAH questionnaires, which were answered by teachers and parents. The mothers and another legal guardian of these children answered a biopsychosocial questionnaire that contained questions concerning their pre, peri and postnatal history, neuropsychomotor development, family environment and questions about ADHD. RESULTS: Findings showed a number of diverse risk factors that may be related with the disorder. Many of these biopsychosocial characteristics were highly prevalent in the children in this study. They cannot, however, be considered to be a cause of the disorder but they may be possible risk factors. CONCLUSIONS: Knowledge of the child's history is important to be able to reach an accurate diagnosis, as well as to try to prevent and treat this syndrome.

Attention Deficit Disorder with Hyperactivity↗

PubMed2005

Effect of stimulant medication on lower extremity response time of boys with attention deficit hyperactivity disorder.

Children with attention deficit hyperactivity disorder (ADHD) have been labeled as "inefficient movers"; however, little research has examined the effect of stimulant medication on lower extremity movements. 16 boys, 11 to 13 years old, with ADHD performed a lower-limb choice-response time task, both on and off medication. When nonmedicated, children had significantly slower reaction times to all three targets and significantly slower movement times for the contralateral and midline movements. For both conditions, children had significantly faster movement time when using the right leg than the left leg. These findings suggest that movement characteristics of children with ADHD are different under medicated and nonmedicated situations.

Adolescent↗

PubMed2000

Family study of girls with attention deficit hyperactivity disorder.

OBJECTIVE: Because attention deficit hyperactivity disorder (ADHD) is relatively infrequent among girls, little is known about the causes of ADHD in girls. To help fill this gap in the literature, the authors assessed the familial transmission of ADHD in families ascertained through girls. METHOD: Interviewers who were blind to diagnosis administered structured psychiatric interviews to 140 girls with ADHD and their 417 first-degree relatives and to 122 girls without ADHD and their 369 first-degree relatives. RESULTS: The relatives of the ADHD girls had a significantly higher prevalence of ADHD, according to either the DSM-III-R or DSM-IV definition, than the relatives of the comparison girls. However, this did not differ from the prevalence the authors reported previously for families of boys with ADHD. Like the boys' families, the relatives of the girl probands also had significantly higher prevalences of antisocial, mood, anxiety, and substance use disorders, although the prevalence of familial antisocial disorders was lower than had been observed in the boys' families. There was no association between the DSM-IV subtypes of the probands and relatives. CONCLUSIONS: The familial transmission of ADHD and comorbid disorders generalizes to families of girls with ADHD. Neither proband gender nor subtype influences the familial transmission of ADHD.

Adolescent↗