Comparison of Electrophysiological Indices of Children With Attention Deficit Hyperactivity Disorder (ADHD) Comorbid With and Without Reading Disorder (ADHD & RD)

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is a neuropsychiatric disorder. Most children and adolescents with ADHD have at least some developmental or mental disorders identified from the early years of elementary school. The most common of these are educational and learning problems in these children, which are probably due to the attention deficits of these children. Therefore, it is expected that the cortical activity pattern of ADHD children is different from ADHD comorbid with learning disabilities, which we have examined in this study.MethodsThis study evaluated the pattern of cortical activity in children 6 to 12 years old with ADHD comorbid with and without the reading disorder (ADHD & RD) using 21-channel electroencephalography. Multivariate analysis of variance with repeated measures in a 2 * 3 * 7 design and T-test was used for statistical analysis.ResultsThe results show that in ADHD children, the activity of different bands increases compared to ADHD comorbid with RD children. In the ADHD group compared to the ADHD comorbid with RD group, the theta/beta ratio in all three regions, especially the anterior region, is higher than the theta/alpha activity in those areas, and this group has significantly higher activity in all three brain regions, especially the anterior region, compared to ADHD comorbid with RD patients.ConclusionsFunctional changes in the left parietal cortex, which is part of the frontoparietal attention network and involved in phonological processing, reading, and calculation, are evident in children with ADHD comorbid with and without the reading disorder (ADHD & RD). However, ADHD without reading disorder shows more activation of the frontoparietal network than ADHD comorbid with reading disorder, and therefore it can be said that ADHD without reading disorder exerts more cognitive control. Therefore, it is likely to be possible to prevent educational problems in these children by using neurofeedback or prescribing drugs that increase the activity of the areas involved in attention.

Poor School-Related Well-Being among Adolescents with Disabilities or ADHD

Poor school-related well-being may influence adolescents’ school performance and lifestyle. Adolescents having disabilities or ADHD are in a vulnerable situation for having poor school-related well-being, compared to adolescents not having disabilities. We used cross-sectional data from a school-based survey among 15–18-year-olds (N = 4071) in Sörmland, Sweden, to analyse the association between poor school-related well-being and disabilities or ADHD. The analyses were carried out by logistic regression models, adjusting for background factors, school-related factors, and health-compromising behaviours. Adolescents having disabilities (n = 827) or ADHD (n = 146) reported that their disability had a negative influence on school. Compared to peers without disability, those having disabilities had an increased chance (OR = 1.40 95% CI: 1.17–1.68) of poor school-related well-being. The corresponding OR was doubled for adolescents reporting ADHD (2.23 95% CI: 1.56–3.18). For the ADHD group, the adjOR for poor school-related well-being remained significant (1.67 95% CI: 1.13–2.50) after adjustments for school-related factors and health-compromising behaviours, but not for the disability group. In conclusion, adolescents having ADHD are a particularly vulnerable group at school, having a greater risk of poor school-related well-being. Schools should actively work to achieve school satisfaction for adolescents having disabilities, to ensure that all students have similar opportunities for favourable development, health and achievement of their academic goals.

The Emergence of ADHD Comorbidity in School-Aged Children with ASD Impacts Resting-State Brain Networks Dynamics

Background: EEG microstates are defined in the literature as quasi-stable topographies of the electric fields in the ongoing EEG, lasting approximately 100 milliseconds and representing the sub-second coherent activation within global functional brain networks. Recently, we found early alterations in the spatio-temporal dynamics and syntax of brain states in toddlers and preschoolers with autism spectrum disorders (ASD) compared to their typically developing (TD) peers.Method: Here, we investigated how these alterations evolve over time and how they are impacted by the emergence of comorbid attention deficit/hyperactivity disorder (ADHD) in ASD among 49 school-aged children (19 children with ASD-only, 15 children with ASD+ADHD, and 15 TD children). Results: We found a decreased prevalence of all temporal parameters of microstate map B in school-aged children with ASD compared to TD peers. Children with ASD+ADHD had a significantly lower prevalence of map B compared to children with ASD-only. Moreover, children with ASD+ADHD had a higher prevalence in time coverage and occurrence for microstate map A than children with ASD-only and TD children. Map E of the ASD+ADHD group has a weaker spatial correlation with map E of ASD-only and TD groups. Moreover, the GEV of map E was significantly decreased for the ASD+ADHD group compared to the ASD-only group. We found that the transition probabilities between maps of the ASD+ADHD group, particularly for map B, differed from ASD-only and TD groups. Exploratory longitudinal analysis showed an increase in all temporal parameters of map B in TD children but a decrease in children with ASD, regardless of the ADHD comorbidity.Limitations: The present study has a small sample size and does not include a group of children with ADHD-only. Conclusion: Our results show that ADHD comorbidity in school-aged children with ASD impacts the spatial organization and the temporal dynamics of whole-brain networks. Further longitudinal studies are needed to understand better the impact of the emergence of ADHD comorbidity in ASD across ages.

Quantifying ADHD Symptoms in Open-Ended Everyday Life Contexts With a New Virtual Reality Task

Objective: To quantify goal-directed behavior and ADHD symptoms in naturalistic conditions, we developed a virtual reality task, EPELI (Executive Performance in Everyday LIving), and tested its predictive, discriminant and concurrent validity. Method: We collected EPELI data, conventional neuropsychological task data, and parent-ratings of executive problems and symptoms in 38 ADHD children and 38 typically developing controls. Results: EPELI showed predictive validity as the ADHD group exhibited higher percentage of irrelevant actions reflecting lower attentional-executive efficacy and more controller movements and total game actions, both indicative of hyperactivity-impulsivity. Further, the five combined EPELI measures showed excellent discriminant validity (area under curve 88 %), while the correlations of the EPELI efficacy measure with parent-rated executive problems (r = .57) and ADHD symptoms (r = .55) pointed to its concurrent validity. Conclusion: We provide a proof-of-concept validation for a new virtual reality tool for ecologically valid assessment of ADHD symptoms.

Altered Functional Connectivity in a Triple-Network Model in Autism With Co-occurring Attention Deficit Hyperactivity Disorder

Purpose: This study aimed to explore alterations in functional connectivity (FC) within and between default mode network (DMN), central executive network, and salience network in autism spectrum disorder (ASD) with co-occurring attention deficit hyperactivity disorder (ADHD).Method: A total of 135 individuals' date of the Autism Brain Imaging Data Exchange II was used to compare the ASD+ADHD group with the ASD group in relation to the abnormal within-network and between-network connectivity of the ASD group relative to the TD group; consequently, the correlation analysis between abnormal FC and behavior was performed.Results: The ASD+ADHD group exhibited decreased within-network connectivity in the precuneus of the ventral DMN compared with the ASD group. Among the three groups, the ASD+ADHD group showed lower connectivity, whereas the ASD group had higher connectivity than the TD group, although the effect of the separate post hoc test was not significant. Meanwhile, the ASD+ADHD group showed increased between-network connectivity between the ventral DMN and dorsal DMN and between the ventral DMN and left executive control network, compared with the ASD and TD groups.Conclusion: Dysfunction of DMN in the “triple-network model” is the core evidence for ASD with co-occurring ADHD.

Emotional dysregulation and health related quality of life in young adults with ADHD: a cross sectional study

Objective Attention Deficit Hyperactivity Disorder (ADHD) is associated with emotional dysregulation (ED) and impaired health related quality of life (HRQoL). However, the role of ED in explaining the relationship between ADHD and HRQoL is unclear. The purpose of the present study was to do so in a sample of non-referred young adults with and without ADHD. Method The study design was cross-sectional. A non-clinical sample of 63 young adults with ADHD (mean age = 24.86 years, SD = 3.25, 78% university students) and 69 gender-matched controls (mean age = 23.84 years, SD = 2.59, 89% university students) were recruited. The Adult ADHD Quality-of-Life scale was used to measure HRQoL; The Self-Report Wender–Reimherr Adult Attention Deficit Disorder Scale and the Difficulties in Emotion Regulation Scale were used to measure ED. Group differences on all measures were tested using univariate and multivariate analyses of covariance, while controlling for age. Finally, a moderation analysis was used in order to examine the impact of ED on HRQoL beyond that accounted for by ADHD symptoms. Results Both HRQoL and ED were significantly worse for the ADHD group compared to the control group. The medication status of the ADHD group participants had no significant effect on the level of ADHD symptoms, ED or HRQoL. ED moderated the effect of ADHD symptoms on HRQoL for the ADHD group. Conclusion The findings support the centrality of ED in ADHD and its crucial influence on HRQoL. Young adults with ADHD and high levels of ED are at risk for aversive impact on their well-being regardless of their ADHD symptoms level.

Attention-Deficit Hyperactivity Disorder and Obesity – A National Study of 1.1 Million Israeli Adolescents

Purpose The incidences of obesity and attention-deficit/hyperactivity disorder (ADHD) have increased in parallel over recent decades. We assessed the association between obesity and ADHD in a national sample of adolescents. Method In a nationwide population-based study of 1,118,315 adolescents (57% males; mean age 17 years), risks of obesity were compared between individuals with severe and mild ADHD, and those without ADHD. Diagnoses of ADHD were confirmed by specialists in either neurology or psychiatry. Adolescents requiring regular and continuous treatment with stimulants with no improvement of symptoms under treatment were classified as having severe ADHD; data were available from 2004 to 2019. During 2015-2019, the diagnosis of ADHD was defined and 65,118 (16.76%) of 388,543 adolescents with mild symptoms who required medications only for learning or who used stimulants irregularly were defined as having mild ADHD. Results The prevalence of severe ADHD was 0.3% and of mild ADHD 20.1%. Obesity was more prevalent among adolescents with severe ADHD than among those without ADHD (13.5% vs. 7.5%). In the mild ADHD group 12.6% of males and 8.4% of females were diagnosed with obesity compared to 9.7% and 6.4%, respectively, in the non-ADHD group. The adjusted odds of severe ADHD for males and females with obesity were 1.77(1.56-2.02) and 2.09 (1.63-2.66) times the odds for low-normal BMI males and females, respectively, and 1.42 (1.37-1.48) and 1.42 (1.34-1.50) for males and females with mild ADHD. The elevated risk persisted in several sensitivity analyses. Conclusions Both adolescents with severe and mild ADHD are at increased risk for obesity.

The Roles of Salience and Value in Inattention Among Children With Attention-Deficit/Hyperactivity Disorder: A Pilot Investigation

Although inattention is a key symptom subdomain of attention-deficit/hyperactivity disorder (ADHD), the mechanisms underlying this subdomain and related symptoms remain unclear. There is a need for more granular approaches that allow for greater specificity in linking disruptions in specific domains of cognitive performance (e.g., executive function and reward processing) with behavioral manifestations of ADHD. Such approaches may inform the development of more targeted therapeutic interventions. Here, we describe the results of a pilot study of elementary-aged children (ages 6–12years) with ADHD (n=50) and typically developing children (n=48) utilizing a cognitive science task designed to target two dissociable mechanisms of attentional selection: a goal-driven mechanism (i.e., reward/value-driven) and a salience-driven mechanism. Participants were asked to optimally extract and combine information about stimulus salience and value to maximize rewards. While results of this pilot study are ambiguous due to the small sample size and limited number of task trials, data suggest that neither participants with ADHD nor typically developing participants performed optimally to maximize rewards, though typically developing participants were somewhat more successful at the task (i.e., more likely to report high-value targets) regardless of task condition. Further, the manuscript examines several follow-up questions regarding group differences in task response times and group differences in task performance as related to sustained attention across the duration of the task. Finally, the manuscript examines follow-up questions related to heterogeneity in the ADHD group (i.e., age, DSM 5 presentation, and comorbid diagnosis) in predicting task performance.

A community detection study: Two replicated distinct subgroups in autistic adults

Psychiatric conditions, such as Autism Spectrum Condition (ASC) are marked by large heterogeneity, which complicates providing tailored support and prognosis. In this study, we aim to identify homogeneous subgroups in autistic adults using community detection. We included 14 variables related to aging with ASC (i.e., demographic, psychological and lifestyle), measured by questionnaires. Community detection analysis was used for subgroup identification in 133 autistic adults and 62 non-autistic comparisons (age 31-89 years). We replicated our findings in a separate sample (Nautistic = 277; Ncomparisons=384; age 30-92 years). For more insight into heterogeneity within ASC, we performed separate community detection analyses in the ASC subsamples. To test the external validity of the ASC subgroups, we compared them on cognitive failures, quality of life, and psychological difficulties. To test specificity, we repeated the community detection analysis after adding 62 adults with ADHD. The ASC and COMP groups formed distinct subgroups. Within the ASC group, we identified three subgroups, of which two were replicated. We identified a “High social, High Grip” subgroup and a “Low social, low grip” subgroup. The “Low social, low grip” reported the most cognitive failures, lowest quality of life, and most psychological difficulties. Addition of an ADHD group did not alter the subgrouping results. Autistic adults are distinct from comparisons on the considered variables. Within autistic adults, one subgroup seems to have less grip on life and could in the long-term benefit from more support, although this must be confirmed in longitudinal and intervention studies.

Declining Trajectories of Co-occurring Psychopathology Symptoms in Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder: A 10-Year Longitudinal Study

Objective: Our objective was to examine developmental trajectories of co-occurring psychopathology symptoms from childhood to young adulthood in individuals with Attention-Deficit/Hyperactivity Disorder (ADHD), individuals with Autism Spectrum Disorder (ASD), and typically developing (TD) individuals.Method: We assessed co-occurring psychopathology symptoms in 61 individuals with ADHD, 26 with ASD, and 40 TD individuals at baseline (T1; Mage = 11.72, 64% boys), 2-year follow up (T2; Mage = 13.77), and 10-year follow up (T3; Mage = 21.35). We analyzed trajectories of internalizing behaviors, externalizing behaviors, and total problems with linear mixed models.Results: From T1 to T3, the ADHD group displayed a small decline in internalizing behaviors (d = −0.49) and large declines in externalizing behaviors (d = −0.78) and total problems (d = −0.71). The ASD group displayed large declines in internalizing behaviors (d = −0.79), externalizing behaviors (d = −0.80), and total problems (d = −0.89). From T1 to T2, the decline in externalizing behaviors and total problems were significantly smaller in the ADHD group compared with the ASD group. The ADHD and the ASD group displayed more co-occurring symptoms compared with the TD group at T3.Conclusion: Individuals with ADHD and ASD, respectively, displayed declines in co-occurring symptoms from childhood to young adulthood. Individuals with ASD displayed an earlier decline compared with individuals with ADHD. Compared with TD individuals, individuals with ADHD and ASD, respectively, continued to display elevated levels of co-occurring symptoms in young adulthood.