Neurobiological marker for child and adult ADHD diagnoses

2017 ◽  
Vol 41 (S1) ◽  
pp. S454-S455
Author(s):  
H. Super ◽  
J. Cañete ◽  
S.V. Faraone ◽  
P. Asherson ◽  
J.A. Ramos-Quiroga
Keyword(s):  
Clinical Diagnosis ◽  
Adult Adhd ◽  
Neurodevelopmental Disorder ◽  
Correct Diagnosis ◽  
Adult Life ◽  
Event Related Potentials ◽  
Hyperactivity Disorder ◽  
Medical Disorders ◽  
Related Potentials ◽  
Core Symptoms

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorder. It is a chronic disease where 50–60% of ADHD cases persist into adult life. ADHD is associated with a range of clinical and psychosocial impairments. In children hyperactivity, impulsivity and inattention are the core symptoms of ADHD. In adults these core symptom are also present but inattention is more prominent. Correct diagnosis of ADHD remains challenging, especially as several other psychiatric and medical disorders show the similar symptomology.ObjectivesThe diagnosis of ADHD is clinical based upon a cluster of symptoms and criteria established by guidelines such as the DSM-5. Yet, objective markers are needed to support the clinical ADHD diagnosis in children and adults. Studies suggest that a neurobiological marker (eye vergence i.e. where the eyes move in opposite directions) can detect ADHD in children and adults. The eyes converge during orienting attention, as evidenced by visual event related potentials at parietal locations. This attention related vergence is impaired in ADHD patients.MethodsWe review the neurobiology and findings of eye vergence and the relevance of its measurement for the clinical diagnosis of ADHD.ResultsNeural circuits underlying eye vergence and attention largely overlap. Using machine learning, eye vergence measurements can classify ADHD in children and adults with high (> 90%) accuracy.ConclusionsEye vergence is a promising candidate for an objective clinical diagnosis of ADHD.Disclosure of interestPart of this research was paid by Braingaze. HS is co-founder and shareholder of Braingaze.

scholarly journals A deep learning approach with event-related spectral EEG data in attentional deficit hyperactivity disorder

2019 ◽  
Author(s):  
Laura Dubreuil-Vall ◽  
Giulio Ruffini ◽  
Joan A. Camprodon
Keyword(s):  
Flanker Task ◽  
Adult Population ◽  
Neurodevelopmental Disorder ◽  
Event Related Potentials ◽  
Clinical Samples ◽  
Learning Approaches ◽  
Time Frequency ◽  
Hyperactivity Disorder ◽  
Related Potentials ◽  
Visualization Techniques

Attention deficit hyperactivity disorder (ADHD) is a heterogeneous neurodevelopmental disorder that affects 5% of the pediatric and adult population worldwide. The diagnosis remains essentially clinical, based on history and exam, with no available biomarkers. In this paper, we describe a deep convolutional neural network (DCNN) for ADHD classification derived from the time-frequency decomposition of electroencephalography data (EEG), particularly of event-related potentials (ERP) during the Flanker Task collected from 20 ADHD adult patients and 20 healthy controls (HC). The model reaches a classification accuracy of 88%, superior to resting state EEG spectrograms and with the key advantage, compared with other machine learning approaches, of avoiding the need for manual selection of EEG spectral or channel features. Finally, through the use of feature visualization techniques, we show that the main features exciting the DCNN nodes are a decreased power in the alpha band and an increased power in the delta-theta band around 100ms for ADHD patients compared to HC, suggestive of attentional and inhibition deficits, which have been previously suggested as pathophyisiological signatures of ADHD. While confirmation with larger clinical samples is necessary, these results highlight the potential of this methodology to develop CNS biomarkers of practical clinical utility.

scholarly journals Pharmacological treatment for attention deficit hyperactivity disorder in adults

2021 ◽  
Vol 64 (1) ◽  
pp. 49-56
Author(s):  
Kukju Kweon
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Neurodevelopmental Disorder ◽  
Self Report ◽  
Hyperactivity Disorder ◽  
The Core ◽  
Symptom Patterns ◽  
Long Acting ◽  
Core Symptoms

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by attention deficits, hyperactivity, and impulsivity. In the past, ADHD was considered to be limited to children and adolescents. However, ADHD has now been reconceptualized as a lifelong disorder, and two-thirds of ADHD patients continue to have core symptoms and dysfunction in adulthood. Currently, the public and clinicians’ interest in adult ADHD is rapidly increasing in Korea. In addition to interviews with patients for an adult ADHD diagnosis, interviews with family members, existing school records, and neuropsychological tests help clinicians to make a diagnosis. It is necessary to check whether the core symptoms of ADHD were expressed in childhood. Since adults’ symptom patterns differ from those of children, a self-report tool designed for adult ADHD is useful. The medications currently approved for ADHD in adults by the Ministry of Food and Drug Safety of Korea are long-acting methylphenidate and atomoxetine. Both methylphenidate and atomoxetine improve the core symptoms of ADHD as well as daily function. Methylphenidate and atomoxetine can be used safely as first-line treatments, and the overall adverse effects are tolerable. However, attention should be paid to possible cardiovascular adverse events and misuse. Bupropion, modafinil, alpha2-agonist, and tricyclic antidepressants can also be used off-label.

scholarly journals Influence of Learning Disabilities on the Neurophysiological and Neuropsychological Health in Athletes with a History of Concussion

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S13.1-S13
Author(s):  
Adam Harrison ◽  
Veronik Sicard ◽  
R. Davis Moore
Keyword(s):  
Depressive Symptoms ◽  
Neurodevelopmental Disorder ◽  
Event Related Potentials ◽  
Test Battery ◽  
Hyperactivity Disorder ◽  
Related Potentials ◽  
Healthy Control ◽  
History Of ◽  
Neurophysiological Test ◽  
Time Since Injury

ObjectiveThe aim of present study was to investigate the role of LD on neuropsychiatric and neurophysiological recovery following concussion.BackgroundIt is estimated that roughly 20% of athletes suffer from a neurodevelopmental disorder (ND). Although concussion research has primarily focused on attention deficit hyperactivity disorder (ADHD), the influence of other NDS, such as learning disorder (LD) on concussion outcomes remains relatively unknown.Design/MethodsSeventy-five athletes (24 healthy control, 24 concussed, and 27 concussed-LD) completed a neuropsychiatric and neurophysiological test battery; including the Beck Depression Inventory (BDI), profile of mood states (POMS), and modified CogState Brain Injury Test battery. Additionally, event-related potentials were recorded during an experimental odd ball task. All athletes were matched based on age, education, BMI, and sport played. Athletes with a history of concussion were further matched on time since injury and number of previous injuries.ResultsConcussion-LD athletes reported significantly greater depressive symptoms compared to matched concussed and healthy control athletes (p < 0.05). When decomposed, the group differences in depressive symptoms were driven by cognitive and affective depression sub-scales (p’s < 0.05), not somatic depression (p > 0.05). Additionally, concussion-LD athletes demonstrated greater cognitive deficits characterized by increased learning errors and decreased working memory (p’s < 0.05). Furthermore, neurophysiological analyses revealed that Concussed-LD athletes exhibited significantly delayed P3b latency (p < 0.05). Finally, irrespective of LD status, athletes with a history of concussion reported increased overall mood disturbances, as well as ratings of anger and hostility compared to controls (p < 0.05).ConclusionsOur results suggest that athletes with concussed athletes with LD may exhibit chronic neuropsychiatric and neurophysiological deficits beyond that of their concussed counterparts (without LD). Further research is needed to better understand the relationship between LD and concussion outcomes.

Neurobiology and Genetics of ADHD in Adults

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S13) ◽  
pp. 5-7 ◽  
Author(s):  
Thomas J. Spencer
Keyword(s):  
Adult Adhd ◽  
Extended Release ◽  
Treatment Strategies ◽  
Stimulant Use ◽  
Hyperactivity Disorder ◽  
Adhd Treatment ◽  
Norepinephrine Reuptake Inhibitor ◽  
Adults And Children ◽  
Core Symptoms ◽  
Adhd Medications

AbstractTreatment of attention-deficit/hyperactivity disorder (ADHD) may positively impact the neurobiology of adult patients with ADHD. Treatment may also minimize impairment from core symptoms and may alter the course of co-morbid disorders such as depression and substance use disorder. However, much of the information on stimulant use in adult ADHD comes from studies conducted in children, and it remains unclear whether there is a difference between children and adults when it comes to the side effects and tolerability of ADHD treatments. It is known that clinical presentation differs between adults and children, with adults demonstrating a higher percentage of mood disorders. Current treatments for adult ADHD include psychosocial therapies and pharmacologic therapies, the latter of which include the stimulants d-methylphenidate extended release (XR), OROS methylphenidate, lisdexamfetamine, and mixed amphetamine salts XR; and the nonstimulant atomoxetine, a selective norepinephrine reuptake inhibitor. There is need for additional study of treatment strategies for adult ADHD. Although all classes of ADHD medications are approved in adults, there are fewer approved formulations for adults than for children. Efficacy in adults is more subjective than in children, which may affect how efficacy rates for adult treatments are calculated. Adults also present a greater diversion risk than children. In addition, there are several new and emerging medication treatments worth considering.This Expert Roundtable Supplement represents part 2 of a 3-part supplement series on adult ADHD led by Lenard A. Adler, MD. In this activity, Thomas J. Spencer, MD, discusses the neurobiology and genetics of adult ADHD; Mark A. Stein, PhD, discusses stimulant therapy; and Jeffrey H. Newcorn, MD, reviews nonstimulants and psychosocial treatments.

Availability of dopamine transporters and auditory P300 abnormalities in adults with attention-deficit hyperactivity disorder: preliminary results

CNS Spectrums ◽  
2017 ◽  
Vol 23 (4) ◽  
pp. 264-270 ◽  
Author(s):  
Ching-Lin Chu ◽  
I Hui Lee ◽  
Mei Hung Chi ◽  
Kao Chin Chen ◽  
Po See Chen ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Photon Emission ◽  
Event Related Potentials ◽  
P300 Amplitude ◽  
Emission Computed Tomography ◽  
Adhd Group ◽  
Hyperactivity Disorder ◽  
Auditory P300 ◽  
Related Potentials

ObjectivePrevious studies have indicated that there is dopamine transporter (DAT) dysregulation and P300 abnormality in adults with attention-deficit hyperactivity disorder (ADHD); however, the correlations among the three have not been fully explored.MethodsA total of 11 adults (9 males and 2 females) with ADHD and 11 age-, sex-, and education-level-matched controls were recruited. We explored differences in DAT availability using single-photon emission computed tomography and P300 wave of event-related potentials between the two groups. The correlation between DAT availability and P300 performance was also examined.ResultsDAT availability in the basal ganglia, caudate nucleus, and putamen was significantly lower in the ADHD group. Adults with ADHD had lower auditory P300 amplitudes at the Pz and Cz sites, as well as longer Fz latency than controls. DAT availability was negatively correlated to P300 latency at Pz and Fz.ConclusionsAdults with ADHD had both abnormal DAT availability and P300 amplitude, suggesting that ADHD is linked to dysfunction of the central dopaminergic system and poor cognitive processes related to response selection and execution.

Pre-, Peri-, and Post-Natal Risk Factors in ADHD

2021 ◽  
pp. 43-54
Author(s):  
Pangajam Ponnuswamy ◽  
Ann Sarah Paul ◽  
Aneesha Brigitte Jose
Keyword(s):  
Risk Factors ◽  
Attention Deficit Hyperactivity Disorder ◽  
Postnatal Development ◽  
Environmental Risk ◽  
Attention Deficit ◽  
Critical Period ◽  
Neurodevelopmental Disorder ◽  
Therapeutic Interventions ◽  
Hyperactivity Disorder ◽  
Core Symptoms

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder most commonly found in childhood with its core symptoms manifesting as inattention, impulsiveness, and hyperactivity. As ADHD generates a substantial rate of burden to the society in terms of economic and medical resources used, priority is given to explore the risk factors that contributes towards the multifactorial origin of this disorder to offer possible preventive and therapeutic interventions. With heritability accounting for 75% to 80% of the variability seen in ADHD, the remaining are explained through environmental risk factors that are exposed during critical period of pre-, peri-, and postnatal development. Though literature on the risk factors have been mostly controversial, certain associations have been made with regards to ADHD pathophysiology.

scholarly journals A hybrid AI approach for supporting clinical diagnosis of attention deficit hyperactivity disorder (ADHD) in adults

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Ilias Tachmazidis ◽  
Tianhua Chen ◽  
Marios Adamou ◽  
Grigoris Antoniou
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Health Systems ◽  
Clinical Diagnosis ◽  
Attention Deficit ◽  
Neurodevelopmental Disorder ◽  
Hybrid Approach ◽  
Public Health Issue ◽  
Hyperactivity Disorder ◽  
The Past ◽  
Increased Risk

AbstractAttention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that includes symptoms such as inattentiveness, hyperactivity and impulsiveness. It is considered as an important public health issue and prevalence of, as well as demand for diagnosis, has increased as awareness of the disease grew over the past years. Supply of specialist medical experts has not kept pace with the increasing demand for assessment, both due to financial pressures on health systems and the difficulty to train new experts, resulting in growing waiting lists. Patients are not being treated quickly enough causing problems in other areas of health systems (e.g. increased GP visits, increased risk of self-harm and accidents) and more broadly (e.g. time off work, relationship problems). Advances in AI make it possible to support the clinical diagnosis of ADHD based on the analysis of relevant data. This paper reports on findings related to the mental health services of a specialist Trust within the UK’s National Health Service (NHS). The analysis studied data of adult patients who underwent diagnosis over the past few years, and developed a hybrid approach, consisting of two different models: a machine learning model obtained by training on data of past cases; and a knowledge model capturing the expertise of medical experts through knowledge engineering. The resulting algorithm has an accuracy of 95% on data currently available, and is currently being tested in a clinical environment.

Treating adult ADHD and comorbid substance-related disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. S54-S54
Author(s):  
J.A. Ramos-Quiroga
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Stimulant Medication ◽  
Behavioral Therapy ◽  
Neurodevelopmental Disorder ◽  
Hyperactivity Disorder ◽  
Competing Interest

Attention-deficit/hyperactivity disorder (ADHD) is a complex, and multifactorial and chronic neurodevelopmental disorder. Comorbid psychiatric disorders are highly prevalent in individuals with a diagnosis of ADHD. There is a solid overlap between ADHD and substance use disorders (SUD). Prevalence of SUD is high among patients with ADHD, so that SUD are approximately double as common among individuals with ADHD than in general population, and individuals with SUD have much higher rates than expected of a comorbid ADHD. Studies shown that treatment during childhood of attention-deficit/hyperactivity disorder with stimulant medication neither protects nor increases the risk of later substance use disorders. Nevertheless, recent studies found that patients with ADHD and SUD can reduce ADHD symptoms and SUD with stimulants and cognitive-behavioral therapy. Treatment of ADHD in patients with SUD requires a comprehensive diagnostic assessment. It is recommendable to stabilize the addiction prior to treating the ADHD. In this talk, the recent literature for the treatment of adults with co-occurring ADHD and SUD will be reviewed.Disclosure of interestThe author has not supplied his declaration of competing interest.

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