Continuous Performance Testing in the Differential Diagnosis of ADHD

2005 ◽  
Vol 13 (5) ◽  
pp. 5-9 ◽  
Author(s):  
Susan R. Homack ◽  
Cecil R. Reynolds
CNS Spectrums ◽  
2004 ◽  
Vol 9 (9) ◽  
pp. 649-659 ◽  
Author(s):  
Mary V. Solanto ◽  
Kenneth Etefia ◽  
David J. Marks

ABSTRACTBackground: Attention-deficit/hyperactivity disorder (ADHD) occurs in as many as 4% of adults yet it is often not recognized in clinical settings because the presenting symptoms may resemble those seen in other disorders or because symptoms may be masked by commonly comorbid conditions such as anxiety and depression.Objective: The purpose of this study was to examine the diagnostic utility of instruments commonly used in the assessment of adults presenting with symptoms of ADHD.Methods: We reviewed several widely used self-report and laboratory measures and empirically examined the utility of the Brown Attention-Deficit Disorder Scale for Adults (Brown ADD Scale) and the Conners Continuous Performance Test (CPT) in differentially identifying adults with ADHD and those with other Axis I disorders.Results:Ninety-three adults who self-referred to the ADHD program for adults at a university medical center participated in the study. Of these, 44 had ADHD combined subtype (ADHD-CB), and 26 had ADHD, predominantly inattentive subtype (ADHD-IA). Thirty-three non-ADHD adults diagnosed with Axis I mood or anxiety disorders comprised an “Other Psychiatric” group. Rates of comorbid disorders, including substance abuse, in the ADHD groups were typical of those reported in the adult ADHD literature. Data on the Brown ADD Scale and on the CPT were available for subsets of 61 and 46 participants, respectively. Analyses showed that the ADHD-CB, ADHD-IA, and Other Psychiatric groups all received mean scores in the clinical range on the Brown ADD Scale, with a trend toward even higher elevations in the two ADHD groups. Among 12 CPT variables assessed for the three groups, the mean scores on only two variables for the ADHD-IA group were clinically elevated. Neither the Brown ADD Scale nor CPT scores evinced sufficient sensitivity and specificity to qualify them to assist in differential diagnosis of ADHD vis-a-vis other, predominantly internalizing, psychiatric disorders.Conclusion: The results indicate a need for closer examination of executive and adaptive functioning in adults with ADHD compared with those with internalizing disorders in order to identify features that could assist in differential diagnosis.


2021 ◽  
Vol 12 ◽  
Author(s):  
Eline B. Provost ◽  
Tim S. Nawrot ◽  
Luc Int Panis ◽  
Arnout Standaert ◽  
Nelly D. Saenen ◽  
...  

Changes in geometry of the retinal microvascular network, including vessel width, vessel density, and tortuosity, have been associated with neurological disorders in adults. We investigated metrics of the retinal microvasculature in association with behavior and cognition in 8- to 12-year-old children. Digital fundus images of 190 children (48.2% girls, mean age 9.9 years) were used to calculate retinal vessel diameters, fractal dimension, lacunarity, and tortuosity. Parents filled out a Strengths and Difficulties Questionnaire (SDQ) for behavioral screening. Cognitive performance testing included a computerized version of the Stroop test (selective attention), the Continuous Performance (sustained attention), the Digit-Symbol (visual scanning and information-processing speed) and the Pattern Comparison (visuospatial analytic ability) tests from the Neurobehavioral Evaluation System (NES3) battery. Retinal vessel geometry was significantly associated with the SDQ problem score, which increased with 1.1 points (95% CI: 0.3 to 1.9 points) per interquartile (IQR) increment in retinal fractal dimension, and decreased 1.4 points (95% CI: −2.4 to −0.4 points) or decreased 1.0 points (95% CI: −2.1 to 0.1 points) per IQR increment in retinal vascular lacunarity or tortuosity, respectively. Sensitivity analyses showed that results were driven by the hyperactivity/inattention and conduct problem scales of the SDQ. Correspondingly, mean reaction time on the Continuous Performance test increased by 11 ms (95% CI: 4.4 to 17.6 ms) with an IQR increase in fractal dimension. The results indicate that a denser retinal microvascular network, exemplified by a higher fractal dimension and lower lacunarity, are inversely associated with behavioral outcomes and sustained attention in children.


Biofeedback ◽  
2016 ◽  
Vol 44 (4) ◽  
pp. 181-205
Author(s):  
Michael Thompson ◽  
Lynda Thompson

This article tracks the evolution of the practice of neurofeedback over the past quarter century from the perspective of services offered at a private clinic. It describes why and how the authors changed their practices from interventions including medication, psychotherapy, and tutoring to biofeedback interventions. Their evolving practices required complex assessments including single- and two-channel quantitative electroencephalograph (QEEG) and later 19-channel QEEG combined with evoked potentials, heart rate variability, continuous performance testing, and neuropsychological assessment. The article stresses that interventions require a multimodal approach. The neuroanatomical rationale for combining neurofeedback and heart rate variability (HRV) training is provided as well as a discussion of how a systems theory of neural synergy helps explain how neurofeedback influences brain networks. Assessment procedures are described in some detail because that information is used to develop effective interventions that typically combine neurofeedback (single-channel or LORETA Z-score neurofeedback, as indicated) with HRV training. The authors stress using evidence-based approaches, basing intervention on assessment, and keeping current with new developments in applied neuroscience.


2016 ◽  
Vol 22 (11) ◽  
pp. 1081-1091 ◽  
Author(s):  
Débora Areces ◽  
Celestino Rodríguez ◽  
Trinidad García ◽  
Marisol Cueli ◽  
Paloma González-Castro

Objective: To analyze the diagnostic effectiveness of the AULA Nesplora test to discriminate the different ADHD presentations: impulsive/hyperactive (I/H), inattentive, and combined.Method: A total of 117 students (76.9% male and 23.1% female) between 5 and 16 years of age ( M = 11.18 years, SD = 3.10 years) participated, and were divided into three groups with ADHD according to their presentation, and a control group. Results: Each of the test conditions allowed the discrimination between the I/H and combined presentations with respect to the control group, and between the I/H and inattentive presentations. However, differences among ADHD presentations were only evident when the results were separately analyzed for the visual and auditory modalities. Conclusion: This study showed that the indicators offered by the AULA Nesplora test (omissions, commissions, response times, and motor activity) make it possible to establish a differential diagnosis of ADHD presentations when analyzed under different contextual conditions.


Author(s):  
Bruce Mackay

The broadest application of transmission electron microscopy (EM) in diagnostic medicine is the identification of tumors that cannot be classified by routine light microscopy. EM is useful in the evaluation of approximately 10% of human neoplasms, but the extent of its contribution varies considerably. It may provide a specific diagnosis that can not be reached by other means, but in contrast, the information obtained from ultrastructural study of some 10% of tumors does not significantly add to that available from light microscopy. Most cases fall somewhere between these two extremes: EM may correct a light microscopic diagnosis, or serve to narrow a differential diagnosis by excluding some of the possibilities considered by light microscopy. It is particularly important to correlate the EM findings with data from light microscopy, clinical examination, and other diagnostic procedures.


2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.


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