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Event-related potentials and performance of attention-deficit hyperactivity disorder: children and normal controls in auditory and visual selective attention tasks.

Attention-deficit hyperactivity disorder (ADHD) children and normal controls (7-13 yrs old) performed an auditory and visual selective attention task. Subjects were instructed to respond to the infrequent (10%) stimuli in the relevant channel. Processing negativity (PN) and several other ERP peaks were scored at the midline electrodes. In the auditory task, controls had more correct detections (hits), less false alarms, larger P3b amplitudes to nontarget stimuli (but not to hits), a larger central PN and larger early frontal positivity (100-250 ms) to target stimuli than ADHD subjects. In the visual modality, controls had more correct detections, less false alarms, larger P3b amplitudes to nontarget stimuli (but not to hits), and larger frontal P3(1) amplitudes to infrequent than to frequent stimuli. It was hypothesized that in ADHD children in both the auditory and the visual task, there is a deficit in the activation of the P3b process. Incorrect triggering of the P3b process might be caused by disturbances in other aspects of the attention process, preceding the P3b.

Adolescent↗

Effects of methylphenidate, desipramine, and L-dopa on attention and inhibition in children with Attention Deficit Hyperactivity Disorder.

The objective of this study was to investigate the effects of methylphenidate (MPH) on attention and inhibition in children with Attention Deficit Hyperactivity Disorder (ADHD) and to establish what the relative contributions of the noradrenergic and dopaminergic systems to this effect were. In addition to MPH, two other drugs were administered in order to affect both transmitter systems more selectively, L-dopa (dopamine (DA) agonist) and desipramine (DMI) (noradrenaline (NA) re-uptake inhibitor). Sixteen children with ADHD performed a stop-task, a laboratory task that measures the ability to inhibit an ongoing action, in a double-blind randomized within-subjects design. Each child received an acute clinical dose of MPH, DMI, L-dopa, and placebo; measures of performance and plasma were determined. The results indicated that inhibition performance was improved under DMI but not under MPH or L-dopa. The response-time to the stop-signal was marginally shortened after intake of DMI. MPH decreased omission and choice-errors and caused faster reaction times to the trials without the stop-tone. No effects of L-dopa whatsoever were noted. Prolactin levels were increased and 5-HIAA levels were lowered under DMI relative to placebo. It is suggested that the effects of MPH on attention are due to a combination of noradrenergic and dopaminergic mechanisms. The improved inhibition under DMI could be serotonergically mediated.

Attention↗

The test of variables of attention (TOVA) is useful in the diagnosis of Japanese male children with attention deficit hyperactivity disorder.

The purpose of this study was to evaluate the ability of the test of variables of attention (TOVA) to distinguish between 6- to 12-year-old Japanese male children with attention deficit hyperactivity disorder (ADHD group; n=17) meeting DSM-IV and ICD-10 criteria, and age-matched, normal Japanese male controls (control group; n=19). The TOVA is a computer-administered, visual continuous performance test that provides measures of attention. The ADHD group had significantly higher means than the control group in all variables: omission errors, commission errors, response time, response time variability, anticipatory responses, and multiple response. Control children exhibited age-related changes in two variables: response time and response-time variability, but no age-related changes were observed in any variables in the ADHD group. This preliminary study indicates that the TOVA makes a useful contribution to the diagnosis of Japanese male children with ADHD.

Age Factors↗

Attention deficit/hyperactivity disorder children with a 7-repeat allele of the dopamine receptor D4 gene have extreme behavior but normal performance on critical neuropsychological tests of attention.

An association of the dopamine receptor D4 (DRD4) gene located on chromosome 11p15.5 and attention deficit/hyperactivity disorder (ADHD) has been demonstrated and replicated by multiple investigators. A specific allele [the 7-repeat of a 48-bp variable number of tandem repeats (VNTR) in exon 3] has been proposed as an etiological factor in attentional deficits manifested in some children diagnosed with this disorder. In the current study, we evaluated ADHD subgroups defined by the presence or absence of the 7-repeat allele of the DRD4 gene, using neuropsychological tests with reaction time measures designed to probe attentional networks with neuroanatomical foci in D4-rich brain regions. Despite the same severity of symptoms on parent and teacher ratings for the ADHD subgroups, the average reaction times of the 7-present subgroup showed normal speed and variability of response whereas the average reaction times of the 7-absent subgroup showed the expected abnormalities (slow and variable responses). This was opposite the primary prediction of the study. The 7-present subgroup seemed to be free of some of the neuropsychological abnormalities thought to characterize ADHD.

Alleles↗

Differentiation of attention-deficit/hyperactivity disorder subtypes: application of a neuropsychological model of attention.

This study represents a neuropsychological attempt to differentiate subtypes of Attention Deficit/Hyperactivity Disorder (ADHD). Participants (N = 80) were grouped by gender and ADHD subtype-Predominantly Inattentive (ADHD-I) versus Combined (ADHD-C)-resulting in four age-matched groups. Statistical analysis revealed significant differences in performance on selective attention tasks for those with ADHD-I and those with ADHD-C. Relative to their counterparts without hyperactivity, participants with ADHD-C earned disproportionately lower scores on tasks associated with executive control. Both subgroups with ADHD-I and ADHD-C demonstrated significant difficulty on some tasks assessing complex mental operations relative to age-standardized normative data. Discriminant analysis revealed that a combination of five neuropsychological measures discriminated between the ADHD-I and ADHD-C subgroups with 80% accuracy. Results provide support for the notion of the Predominantly Inattentive and Combined subtype classifications as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (American Psychiatric Association, 1994). Further, findings from this study lend preliminary support for the utility of a neurophysiologically sensitive model of attention in the differentiation of these subtypes.

Attention↗

Sustained attention and executive functioning performance in attention-deficit/hyperactivity disorder.

The aim of this study was to further refine the cognitive phenotype of attention-deficit/hyperactivity disorder (ADHD), with respect to the ability to sustain attention and executive functioning. Participants were 34 boys with ADHD (combined type) and 28 normal controls. The groups were closely matched for age and IQ. All participants were 12 years of age. Both groups performed a computerized sustained attention task and a response interference task. Measures related to speed, accuracy, and time on task were collected. We found that children with ADHD performed slower, less accurately, more impulsively, and with less stability than controls. Both groups produced more errors with increasing time on task, reflecting reduced vigilance. Importantly, no interaction with time on task was found. The overall pattern of results suggests that measures related to accuracy are more informative than measures related to speed of responding in refining the cognitive phenotype of ADHD.

Attention↗

Autism and attention deficit hyperactivity disorder: assessing attention and response control with the integrated visual and auditory continuous performance test.

Symptoms of attention deficit hyperactivity disorder (ADHD) have been widely reported in children with autism spectrum disorder (ASD). The current study investigated attention and response control in children with ASD, ADHD, and typical development using the Integrated Visual and Auditory Continuous Performance Test. Results indicate that many children with ASD show significant deficits in visual and auditory attention and greater deficits in impulsivity than children with ADHD or typical development. These findings suggest that many of the children with ASD demonstrate significant ADHD-like deficits. These findings are discussed in the context of symptoms, subtypes, and comorbidity.

Analysis of Variance↗

Effects of methylphenidate on attention and nonverbal learning in children with attention-deficit hyperactivity disorder.

OBJECTIVE: To examine effects of methylphenidate (MPH) doses on attention and learning tasks requiring varying levels of processing in 23 children with attention-deficit hyperactivity disorder. METHOD: Performance on a continuous performance task (CPT) and two difficulty levels of a nonverbal learning task was evaluated on two doses of MPH (0.3 mg/kg and 0.8 mg/kg) and placebo. RESULTS: CPT commission errors were significantly reduced with low-dose MPH compared with placebo while omission errors were not medication-sensitive. Performance on nonverbal learning tasks was significantly improved with MPH. On the easy level of the nonverbal learning task performance improved equally well with either dose. On the hard level, performance was significantly better at the high dose compared with placebo; no between-dose differences emerged across learning trials. However, the high dose was superior to low and placebo doses in memory recall trials. CONCLUSIONS: Impulsivity may be reduced on an attentional task with a low dose of MPH, and a high dose of MPH may optimize retention and recall of complex nonverbal information.

Analysis of Variance↗

Handwriting and attention in children and adults with attention deficit hyperactivity disorder.

Adverse effects of drug therapy on handwriting fluency attributed to increased attentional control have been observed in children with attention deficit hyperactivity disorder (ADHD). The writing performance of 8 children with ADHD was assessed using a digitizing tablet in a double-blind, placebo-controlled test. Participants wrote a phrase in cursive script both on and off stimulant medication writing normally, writing with eyes closed, and writing faster than normal. Medication reduced fluency of normal handwriting movements. When children with ADHD were instructed to write faster than normal or with eyes closed, however, more fluent and even automated movements resulted, even on medication. We also assessed 10 children with ADHD, 10 children without ADHD, 10 adults with ADHD, and 10 adults without ADHD. Participants with ADHD were assessed both on and off medication. Children with ADHD on medication were less fluent than children without ADHD. Without medication, Children with ADHD did not differ from children without ADHD; those on medication showed increased handwriting dysfluency. There was no significant difference between the adults. Both children and adults with ADHD could perform age-appropriate and automated handwriting movements. Children with ADHD on medication, however, gave more attention to the writing process, possibly hampering fluent handwriting movements.

Adult↗

Attention deficits in newly abstinent substance abusers: childhood recollections and attention performance in thirty-nine subjects.

Attention deficits were studied among 67 consecutive admissions to an adult tertiary care in-patient substance abuse unit. Fifty-four patients completed the testing; of these 15 were excluded due to confounding variables. The majority of the remaining 39 subjects had evidence of current and/or childhood attention dysfunction. There was no correlation with current performance and childhood recollection of dysfunction even when the effect of gender, race and alcohol abuse were taken into account. There are intriguing educational and therapeutic implications of the similarities between cognitive impairments of newly sober substance abusers and adults with persistence of attention deficit-hyperactivity disorder (ADHD).

Adult↗

Measurement of attention deficit: correspondence between rating scales and tests of sustained and selective attention.

The correspondence between teachers' ratings of students' attention and measures of sustained and selective attention was examined. Subjects were 26 adolescents who were selected on the basis of ratings from among 100 students with educable mental retardation (EMR). The top 13 and the bottom 13 subjects in the ratings were designated as the good and the poor attenders. A 10-minute auditory vigilance test and an adapted version of Posner's physical and name identity task were given to the good and poor attenders. Results showed that whereas the vigilance task did not discriminate between the two groups, the Posner's task did. The former group was faster than the latter in both physical- and name-matching, suggesting that groups divided in attention ratings by teachers could be differentiated by increasing the strength of distractors.

Adolescent↗

Components of attention, methylphenidate dosage, and blood levels in children with attention deficit disorder.

In this study we analyzed some of the cognitive components that may constitute attention deficit disorder. It consisted of a double-blind, drug-placebo study of 12 children being treated with three doses of methylphenidate and placebo. Results of an attentional test battery, teacher and parent ratings, and blood levels of methylphenidate are reported. In general, performance was best with 0.6 mg/kg of methylphenidate (the highest dose tested) and worst with placebo. It is argued that no single test provides a complete assessment of attentional deficits and that methylphenidate can improve performance by affecting the allocation of cognitive resources to a task.

Adolescent↗

Attention deficit disorder and the effect of methylphenidate on attention, behavioral, and cardiovascular functioning.

The effect of a 0.3 mg/kg dose of methylphenidate on attentional, behavioral, and cardiovascular measures in boys with attention deficit disorder (ADD) was examined. The results of double-blind clinical trials demonstrated a significant improvement in sustained attention and impulse control, as well as in ratings of social behavior by both teachers and parents. Consistent with previous research, cardiovascular functioning did not significantly increase as a function of methylphenidate. Due to the large intraindividual variability in cardiovascular response, careful monitoring of each patient's response is recommended.

Attention↗

Biological correlates of learning and attention: what is relevant to learning disability and attention-deficit hyperactivity disorder?

Advances in the related fields of cognitive neuroscience and neuropsychology offer intriguing reformulations of the clinical entities of attention-deficit hyperactivity disorder (ADHD) and learning disabilities (LD). The definition of such terms as attention and learning used in cognitive neuroscience differ from their use in clinical practice and emphasize such processes as intention, working memory, and executive function. Research suggests that neither attention nor long-term memory are the critical cognitive correlates of ADHD or LD. Rather, encoding processes, particularly working memory, are identified as deficiencies for children with these conditions. Furthermore, intention and inhibition appear to be particularly impaired in children with ADHD, who exhibit broader deficits in so-called executive function. Findings from cognitive neuroscience offer explanations of the neuroanatomical and neurophysiological underpinnings of learning problems and the frequent comorbidity of LD and ADHD.

Attention↗

Differential use of attentional and visual communicative signaling by orangutans (Pongo pygmaeus) and gorillas (Gorilla gorilla) in response to the attentional status of a human.

In this study we investigated the communicative abilities of 10 orangutans (Pongo pygmaeus) and seven western lowland gorillas (Gorilla gorilla gorilla), and particularly focused on their sensitivity to the attentional state of a human experimenter when choosing from a repertoire of both auditory and visual communication strategies. In experiment 1 a banana was placed in front of the subject's cage and a human experimenter was either present or absent. The subject's behavior was recorded for 60 sec. Both gorillas and orangutans gestured (t(16)=-3.58, P<.005) and vocalized (t(16)=-2.47, P<.05) more when the experimenter was present. In experiment 2 a human experimenter held a banana in front of the subject's cage and was oriented either toward or away from the subject. Again the subject's behavior was recorded for 60 sec. In this experiment both gorillas and orangutans gestured significantly more frequently (t(16)=3.40, P<.005) when the experimenter was oriented toward them. In addition, gorillas and orangutans used other forms of visual communication signals, such as lip pout (t(16)=3.66, P<.005), barter/trade (t(16)=2.31, P<.05), and body present (t(16)=2.31, P<.05) significantly more when an experimenter was facing them. The overall results indicate that both gorillas and orangutans are sensitive to the attentional state of a human experimenter and use appropriate communicative signals to gain that individual's attention. These results are also similar to previous findings on communicative behaviors in chimpanzees.

Animal Communication↗

Attentional awakening: gradual modulation of temporal attention in rapid serial visual presentation.

Orienting attention to a point in time facilitates processing of an item within rapidly changing surroundings. We used a one-target RSVP task to look for differences in accuracy in reporting a target related to when the target temporally appeared in the sequence. The results show that observers correctly report a target early in the sequence less frequently than later in the sequence. Previous RSVP studies predicted equivalently accurate performances for one target wherever it appeared in the sequence. We named this new phenomenon attentional awakening, which reflects a gradual modulation of temporal attention in a rapid sequence.

Adult↗

Effects of different attentional cues on responding to joint attention in younger siblings of children with autism spectrum disorders.

We compared responding to joint attention (RJA) in younger siblings of children with ASD (SIBS-ASD; n = 46) and younger siblings of children developing typically (SIBS-TD; n = 35). Children were tested between 12 and 23 months of age in a situation in which an experimenter directed the child's attention to one of 8 targets. Each child responded to 10 different combinations of verbal and nonverbal cues containing varying levels of attention-specifying information. SIBS-ASD had significantly lower overall RJA scores than SIBS-TD. Moderately redundant cues were most difficult for SIBS-ASD relative to SIBS-TD; adding a point to moderately redundant cues improved RJA for SIBS-ASD, bringing them to a level of RJA commensurate with SIBS-TD.

Attention↗