A comprehensive assessment of memory, delay aversion, timing, inhibition, decision making and variability in attention deficit hyperactivity disorder: advancing beyond the three-pathway models

2013 ◽  
Vol 44 (9) ◽  
pp. 1989-2001 ◽  
Author(s):  
D. R. Coghill ◽  
S. Seth ◽  
K. Matthews

BackgroundAlthough attention deficit hyperactivity disorder (ADHD) has been associated with a broad range of deficits across various neuropsychological domains, most studies have assessed only a narrow range of neuropsychological functions. Direct cross-domain comparisons are rare, with almost all studies restricted to less than four domains. Therefore, the relationships between these various domains remain undefined. In addition, almost all studies included previously medicated participants, limiting the conclusions that can be drawn. We present the first study to compare a large cohort of medication-naive boys with ADHD with healthy controls on a broad battery of neuropsychological tasks, assessing six key domains of neuropsychological functioning.MethodThe neuropsychological functioning of 83 medication-naive boys with well-characterized ADHD (mean age 8.9 years) was compared with that of 66 typically developing (TYP) boys (mean age 9.0 years) on a broad battery of validated neuropsychological tasks.ResultsData reduction using complementary factor analysis (CFA) confirmed six distinct neuropsychological domains: working memory, inhibition, delay aversion, decision making, timing and response variability. Boys with ADHD performed less well across all six domains although, for each domain, only a minority of boys with ADHD had a deficit [effect size (% with deficit) ADHD versus TYP: working memory 0.95 (30.1), inhibition 0.61 (22.9), delay aversion 0.82 (36.1), decision making 0.55 (20.5), timing 0.71 (31.3), response variability 0.37 (18.1)].ConclusionsThe clinical syndrome of ADHD is neuropsychologically heterogeneous. These data highlight the complexity of the relationships between the different neuropsychological profiles associated with ADHD and the clinical symptoms and functional impairment.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alekhya Mandali ◽  
Arjun Sethi ◽  
Mara Cercignani ◽  
Neil A. Harrison ◽  
Valerie Voon

AbstractRisk evaluation is a critical component of decision making. Risk tolerance is relevant in both daily decisions and pathological disorders such as attention-deficit hyperactivity disorder (ADHD), where impulsivity is a cardinal symptom. Methylphenidate, a commonly prescribed drug in ADHD, improves attention but has mixed reports on risk-based decision making. Using a double-blinded placebo protocol, we studied the risk attitudes of ADHD patients and age-matched healthy volunteers while performing the 2-step sequential learning task and examined the effect of methylphenidate on their choices. We then applied a novel computational analysis using the hierarchical drift–diffusion model to extract parameters such as threshold (‘a’—amount of evidence accumulated before making a decision), drift rate (‘v’—information processing speed) and response bias (‘z’ apriori bias towards a specific choice) focusing specifically on risky choice preference. Critically, we show that ADHD patients on placebo have an apriori bias towards risky choices compared to controls. Furthermore, methylphenidate enhanced preference towards risky choices (higher apriori bias) in both groups but had a significantly greater effect in the patient population independent of clinical scores. Thus, methylphenidate appears to shift tolerance towards risky uncertain choices possibly mediated by prefrontal dopaminergic and noradrenergic modulation. We emphasise the utility of computational models in detecting underlying processes. Our findings have implications for subtle yet differential effects of methylphenidate on ADHD compared to healthy population.


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)


2015 ◽  
Vol 233 (2) ◽  
pp. 233-242 ◽  
Author(s):  
Hanneke van Ewijk ◽  
Wouter D. Weeda ◽  
Dirk J. Heslenfeld ◽  
Marjolein Luman ◽  
Catharina A. Hartman ◽  
...  

2005 ◽  
Vol 35 (1) ◽  
pp. 73-88
Author(s):  
J. B. Savitz ◽  
P. Jansen

The literature on the neuropsychology of Attention Deficit Hyperactivity Disorder (ADHD) is plagued by inconsistent findings, which are usually attributed to a variety of extraneous variables. One of the most inadequately explored of these variables is the difference between ADHD children attending remedial and mainstream schools. This study aimed to investigate whether the performance of remedial and mainstream school ADHD boys differs on relevant neuropsychological tasks. The sample consisted of three groups of 8- to 12-year-old boys. Two of these groups consisted of children with ADHD: one from remedial schools and one from mainstream schools. The third group was made up of participants without ADHD, who attended mainstream schools. The performance of the remedial school learners on the Stroop, Lurian and cancellation tasks was investigated and compared to a mainstream school ADHD sample. The performance of the ADHD group as a whole was compared with that of a control group. No significant difference in performance was found between the two ADHD groups, except for the length of time taken to read words in the control condition of the Stroop. The control group out-performed the ADHD samples on the Stroop, Lurian and cancellation tasks. The findings suggest that mainstream and remedial ADHD boys do not differ in the severity of their executive deficits, but that boys with ADHD attending remedial schools may be more likely to have another learning disorder than their counterparts at mainstream schools.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ana Moreno-Alcázar ◽  
Josep A. Ramos-Quiroga ◽  
Marta Ribases ◽  
Cristina Sánchez-Mora ◽  
Gloria Palomar ◽  
...  

AbstractPrevious studies have shown that the gene encoding the adhesion G protein-coupled receptor L3 (ADGRL3; formerly latrophilin 3, LPHN3) is associated with Attention-Deficit/Hyperactivity Disorder (ADHD). Conversely, no studies have investigated the anatomical or functional brain substrates of ADGRL3 risk variants. We examined here whether individuals with different ADGRL3 haplotypes, including both patients with ADHD and healthy controls, showed differences in brain anatomy and function. We recruited and genotyped adult patients with combined type ADHD and healthy controls to achieve a sample balanced for age, sex, premorbid IQ, and three ADGRL3 haplotype groups (risk, protective, and others). The final sample (n = 128) underwent structural and functional brain imaging (voxel-based morphometry and n-back working memory fMRI). We analyzed the brain structural and functional effects of ADHD, haplotypes, and their interaction, covarying for age, sex, and medication. Individuals (patients or controls) with the protective haplotype showed strong, widespread hypo-activation in the frontal cortex extending to inferior temporal and fusiform gyri. Individuals (patients or controls) with the risk haplotype also showed hypo-activation, more focused in the right temporal cortex. Patients showed parietal hyper-activation. Disorder-haplotype interactions, as well as structural findings, were not statistically significant. To sum up, both protective and risk ADGRL3 haplotypes are associated with substantial brain hypo-activation during working memory tasks, stressing this gene’s relevance in cognitive brain function. Conversely, we did not find brain effects of the interactions between adult ADHD and ADGRL3 haplotypes.


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