Abnormal executive function in attention deficit hyperactivity disorder: the effect of stimulant medication and age on spatial working memory

2001 ◽  
Vol 31 (6) ◽  
pp. 1107-1115 ◽  
Author(s):  
R. BARNETT ◽  
P. MARUFF ◽  
A. VANCE ◽  
E. S. L. LUK ◽  
J. COSTIN ◽  
...  

Objective. This study sought to examine the factors associated with spatial working memory and the use of strategies to impairments in spatial working memory in children with attention deficit hyperactivity disorder (ADHD). The developmental trajectories for spatial working memory in medicated and medication naïve children with ADHD were investigated. In addition, the effect of psychostimulant medication on deficits in spatial working memory was examined.Method. A cross-sectional study compared performance between 21 psychostimulant medicated children with ADHD, 27 medication naïve children with ADHD and 26 matched control subjects on computerized tests of spatial memory and spatial working memory.Results. Compared with the controls, performance in medication naïve children with ADHD was significantly worse on the spatial working memory task. There was no difference in performance between the medicated children with ADHD and the control subjects on this same task, despite the ongoing symptoms of ADHD in the former group. The pattern of normal and abnormal performance in the ADHD groups was age-independent.Conclusions. Deficits in executive functions related to spatial working memory do occur in children with ADHD, although the magnitude of these deficits is not related to the child's age or the level of ADHD symptoms. These deficits were not present in the current sample of children who were receiving psychostimulant medication.

2018 ◽  
Vol 49 (4) ◽  
pp. 590-597 ◽  
Author(s):  
Rachel Muster ◽  
Saadia Choudhury ◽  
Wendy Sharp ◽  
Steven Kasparek ◽  
Gustavo Sudre ◽  
...  

AbstractBackgroundWhile the neuroanatomic substrates of symptoms of attention deficit hyperactivity disorder (ADHD) have been investigated, less is known about the neuroanatomic correlates of cognitive abilities pertinent to the disorder, particularly in adults. Here we define the neuroanatomic correlates of key cognitive abilities and determine if there are associations with histories of psychostimulant medication.MethodsWe acquired neuroanatomic magnetic resonance imaging data from 264 members of 60 families (mean age 29.5; s.d. 18.4, 116 with ADHD). Using linear mixed model regression, we tested for associations between cognitive abilities (working memory, information processing, intelligence, and attention), symptoms and both cortical and subcortical volumes.ResultsSymptom severity was associated with spatial working memory (t = −3.77, p = 0.0002), processing speed (t = −2.95, p = 0.004) and a measure of impulsive responding (t = 2.19, p = 0.03); these associations did not vary with age (all p > 0.1). Neuroanatomic associations of cognition varied by task but centered on prefrontal, lateral parietal and temporal cortical regions, the thalamus and putamen. The neuroanatomic correlates of ADHD symptoms overlapped significantly with those of working memory (Dice's overlap coefficient: spatial, p = 0.003; verbal, p = 0.001) and information processing (p = 0.02). Psychostimulant medication history was associated with neither cognitive skills nor with a brain–cognition relationships.ConclusionsDiagnostic differences in the cognitive profile of ADHD does not vary significantly with age; nor were cognitive differences associated with psychostimulant medication history. The neuroanatomic substrates of working memory and information overlapped with those for symptoms within these extended families, consistent with a pathophysiological role for these cognitive skills in familial ADHD.


2005 ◽  
Vol 35 (10) ◽  
pp. 1433-1443 ◽  
Author(s):  
R. BARNETT ◽  
P. MARUFF ◽  
A. VANCE

Background. Memory impairment is not considered a core cognitive feature of attention deficit hyperactivity disorder, combined type (ADHD-CT), although it is associated with impairments in attentional and executive functions. This study investigates visuospatial memory impairment, in particular encoding and retrieval aspects, in children with ADHD-CT who are stimulant-medication naive and medicated with stimulant medication.Method. A cross-sectional study of visuospatial memory in 6- to 12-year-old children with stimulant-medication-naive ADHD-CT (n=62) and medicated ADHD-CT (n=58) compared to an age- and gender-matched healthy control group (n=39) was completed.Results. Both medication-naive and medicated ADHD-CT groups demonstrated subtle yet significant impairment in visuospatial memory. The memory impairment was delay-independent, which, along with other factors, suggest dysfunction of the encoding rather than retrieval phase of visuospatial memory.Conclusions. Careful study of large ADHD-CT samples does detect deficits in a visuospatial memory task, but these reflect attentional deficits rather than being specifically due to dysfunction of the medial temporal lobe explicit memory system. Children with ADHD-CT may benefit from cognitive and behavioural strategies focused on improving encoding of relevant information rather than retrieval strategies.


1999 ◽  
Vol 29 (3) ◽  
pp. 527-538 ◽  
Author(s):  
S. KEMPTON ◽  
A. VANCE ◽  
P. MARUFF ◽  
E. LUK ◽  
J. COSTIN ◽  
...  

Background. Executive function deficits have been reported repeatedly in children with Attention Deficit Hyperactivity Disorder (ADHD). Stimulant medication has been shown to be effective in improving cognitive performance on most executive function tasks, but neuropsychological tests of executive function in this population have yielded inconsistent results. Methodological limitations may explain these inconsistencies. This study aimed to measure executive function in medicated and non-medicated children with ADHD by using a computerized battery, the Cambridge Neuropsychological Test Automated Battery (CANTAB), which is sensitive to executive function deficits in older patients with frontostriatal neurological impairments.Methods. Executive function was assessed in 30 children with ADHD: 15 were stimulant medication naïve and 15 were treated with stimulant medication. These two groups were compared to 15 age, sex and IQ matched controls.Results. The unmedicated children with ADHD displayed specific cognitive impairments on executive function tasks of spatial short-term memory, spatial working memory, set-shifting ability and planning ability. Impairments were also seen on spatial recognition memory and delayed matching to sample, while pattern recognition memory remained intact. The medicated children with ADHD were not impaired on any of the above executive function tasks except for deficits in spatial recognition memory.Conclusions. ADHD is associated with deficits in executive function. Stimulant medication is associated with better executive function performance. Prospective follow-up studies are required to examine these effects.


2015 ◽  
Vol 22 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Ashley N. Simone ◽  
Anne-Claude V. Bédard ◽  
David J. Marks ◽  
Jeffrey M. Halperin

AbstractThe aim of this study was to examine working memory (WM) modalities (visual-spatial and auditory-verbal) and processes (maintenance and manipulation) in children with and without attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 63 8-year-old children with ADHD and an age- and sex-matched non-ADHD comparison group (N=51). Auditory-verbal and visual-spatial WM were assessed using the Digit Span and Spatial Span subtests from the Wechsler Intelligence Scale for Children Integrated - Fourth Edition. WM maintenance and manipulation were assessed via forward and backward span indices, respectively. Data were analyzed using a 3-way Group (ADHD vs. non-ADHD)×Modality (Auditory-Verbal vs. Visual-Spatial)×Condition (Forward vs. Backward) Analysis of Variance (ANOVA). Secondary analyses examined differences between Combined and Predominantly Inattentive ADHD presentations. Significant Group×Condition (p=.02) and Group×Modality (p=.03) interactions indicated differentially poorer performance by those with ADHD on backward relative to forward and visual-spatial relative to auditory-verbal tasks, respectively. The 3-way interaction was not significant. Analyses targeting ADHD presentations yielded a significant Group×Condition interaction (p=.009) such that children with ADHD-Predominantly Inattentive Presentation performed differentially poorer on backward relative to forward tasks compared to the children with ADHD-Combined Presentation. Findings indicate a specific pattern of WM weaknesses (i.e., WM manipulation and visual-spatial tasks) for children with ADHD. Furthermore, differential patterns of WM performance were found for children with ADHD-Predominantly Inattentive versus Combined Presentations. (JINS, 2016, 22, 1–11)


Author(s):  
Tessa L. Rausch ◽  
Diane L. Kendall ◽  
Sara T. Kover ◽  
Elizabeth M. Louw ◽  
Ursula L. Zsilavecz ◽  
...  

Background and objective: Children with attention-deficit hyperactivity disorder (ADHD) experience difficulty with expressive language, including form (e.g. grammatical construction) and content (e.g. coherence). The current study aimed to investigate the effect of methylphenidate-Osmotic Release Oral System® (MPH-OROS®) on the narrative ability of children with ADHD and language impairment, through the analysis of microstructure and macrostructure narrative elements.Method: In a single group off–on medication test design, narratives were obtained from 12 children with ADHD, aged 7–13 years, using wordless picture books. For microstructure, number of words, type–token ratio and mean length of utterance were derived from narrative samples using Systematic Analysis of Language Transcripts conventions. For macrostructure, the narratives were coded according to the Narrative Scoring Scheme, which includes seven narrative characteristics, as well as a composite score reflecting the child’s overall narrative ability.Results: The administration of MPH-OROS® resulted in a significant difference in certain aspects of language macrostructure: cohesion and overall narrative ability. Little effect was noted in microstructure elements.Conclusion: We observed a positive effect of stimulant medication on the macrostructure, but not on the microstructure, of narrative production. Although stimulant medication improves attention and concentration, it does not improve all aspects of language abilities in children with ADHD. Language difficulties associated with ADHD related to language content and use may be more responsive to stimulant medication than language form, which is likely to be affected by cascading effects of inattention, hyperactivity and impulsivity beginning very early in life and to progress over a more protracted period. Therefore, a combination of treatments is advocated to ensure that children with ADHD are successful in reaching their full potential.


Author(s):  
Raghumahanti Raghuveer ◽  
. Ruchi

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) may develop during the preschool years of the child and extend into adulthood. ADHD also leads to impaired Working Memory (WM) creating problems in various functions. Aim: To compare the effectiveness of behavioural parent training and structured games on WM of children with ADHD. Materials and Methods: This prospective interventional study was conducted in 18 schools of Ghaziabad City, Uttar Pradesh, India. Seventy subjects were selected based on Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria. Group A (n=35) received structured games and Group B (n=35) received Behavioural Parent Training (BPT). Seguin Form Board Test Time (SFBTT) was recorded as outcome on baseline and 5th week. Student’s paired and unpaired t-test was done. SPSS 22.0 version was the software used and p<0.05 was considered as level of significance. Results: Analysed data showed significant results within structured games group with t=2.355, p<0.05, and no significant result within BPT group with t=-0.776, p>0.05. Between group comparison showed significant difference with t=-2.804, p<0.05. Conclusion: Training of WM in form of structured games can be an effective method when compared to BPT in children with ADHD.


2013 ◽  
Vol 20 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Jane E. Schreiber ◽  
Katherine L. Possin ◽  
Jonathan M. Girard ◽  
Celiane Rey-Casserly

AbstractTheories of attention deficit/hyperactivity disorder (ADHD) increasingly highlight the role of neuropsychological impairment in ADHD; however, a consistent and identifiable pattern of performance on tests is not well established. The National Institutes of Health (NIH) Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER) battery provides measures of common variance across multiple executive function tests within specific domains and was used to characterize which executive functions are most affected in children with ADHD. Thirty-two children (24 male), ages 8–15 years (M = 12.02; SD = 2.29), diagnosed with ADHD and no comorbid disorder completed the NIH EXAMINER battery. Sixty age and gender matched healthy controls were chosen from a database of participants enrolled in the NIH EXAMINER multi-site study. Children with ADHD performed worse on the working memory score compared with the controls. No differences were found on the cognitive control or fluency scores. For children with ADHD, poorer working memory performance predicted parent report of child learning problems. Cognitive control and fluency scores did not predict learning problems. In summary, working memory emerges as a primary impairment in children with ADHD who have no comorbid disorders. Furthermore, working memory weaknesses may underlie the academic problems often seen in children with ADHD. (JINS, 2013, 19, 1–11)


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