Assessing brain iron and its relationship to cognition and comorbidity in children with ADHD with quantitative susceptibility mapping (QSM).

BACKGROUND: Quantitative susceptibility mapping (QSM) is a neuroimaging technique that detects local changes in magnetic susceptibility induced by brain iron. Brain iron and the dopaminergic system are linked since iron is an important cofactor for dopamine synthesis. ADHD is associated with dysregulation of dopaminergic transmission. Therefore, we applied QSM on subcortical structures, to study potential alterations in brain iron and its impact on cognition and mental health in children with ADHD. METHODS: 3 Tesla QSM-data of 111 participants (nADHD= 58, mean age: 13.2 (0.63); nControls=53, mean age: 13.2 (0.51)) were analyzed. Subcortical regional brain iron values were extracted. ANOVAs examined group differences for each region of interest. For dimensional approaches, Pearson correlation analysis was performed across the cohort examining the association with symptoms, mental health, and cognition. RESULTS: No significant differences were found in iron susceptibility between ADHD and control, between persistent and remitted ADHD, or between medication use. An unexpected finding was that children with internalising disorder had significantly higher iron susceptibility, but the result did not survive multiple comparison corrections. Higher brain iron was associated with sustained attention, but not on inhibition, IQ, and working memory. CONCLUSION: This is the first study addressing brain iron susceptibility and its association with comorbidities and cognition in ADHD. Alterations in brain iron may not account for the full diagnosis of ADHD but may be an indicator of internalising problems in children. Alterations in brain iron content in children were linked to detrimental sustained attention and may represent developmental variation in cognition.

Therapeutic alliance in individual adult psychotherapy: a systematic review of conceptualizations and measures for face-to-face- and online-psychotherapy.

Background: The therapeutic alliance (TA) is a robust and pantheoretical predictor of treatment outcome in Face-to-Face- (F2F-) and Online-psychotherapy (Online-PT). Many authors have proposed several conceptualizations of TA, which are oftentimes operationalized. The resulting diversity of conceptualizations and measures is presented in this review. Methods: We performed a three-parted literature search for self-report-instruments of TA in individual, voluntary F2F-PT with adults (1. utilization of past reviews, 2. systematic literature search yielding 5,205 articles, 3. reference lists). Analogously, we conducted a systematic literature search for instruments of TA in the Online-setting (yielding 200 articles). Additionally, we analyzed the content of the instruments qualitatively. Results: A current overview of 48 instruments for measuring TA (46 for F2F-PT, 2 for Online-PT) including their conceptual backgrounds, characteristics and main content aspects is presented. Most instruments (n = 24) operationalize one or more theoretical conceptualizations of TA. Other instruments are adaptation/syntheses of existing measures (n = 14), based on literature searches (n = 3) or on an empirical survey (n = 3) and two instruments provide no conceptual background information. The content of the instruments mainly focused on the following aspects: 1. Self-disclosure and authenticity; 2. Agreement; 3. Active participation, motivation and compliance; 4. Trust and secure attachment; and 5. Considering needs/abilities/wishes of the patient. Additionally, a narrative review of various approaches to conceptualize TA is presented and linked to respective corresponding instruments. Discussion: The broad variety of conceptualizations and measures of TA makes coherent research on TA difficult. There are conceptual challenges such as the role of attachment style in TA that remain to be clarified. The current conceptualizations and measures do not incorporate the practical experience and expertise of psychotherapists and patients sufficiently. A metatheoretical conceptualization and measure of TA based on an empirical survey of psychotherapists and patients could address these issues.

Validity of leg length measurement in the supine and standing position compared with pelvic survey X-ray after total hip arthroplasty.

INTRODUCTION: The correct adjustment of leg length is a major goal in the implantation of total hip replacements (THRs). Differences in leg length can lead to functional impairment and patient dissatisfaction. By determining leg length at an early stage, before the patient is discharged from hospital, compensatory measures such as the production of special insoles or orthopaedic footwear can be initiated promptly if there is a difference in leg length. Due to shortening of the period of time spent in hospital, the traditional measurement of leg length in a standing position may be increasingly subject to error. A protective posture immediately after surgery or the presence of a twisted pelvis, for example, due to scoliotic spinal misalignments, falsifies the measurement result in the standing position. Here, the measurement of leg length in the supine position may prove to be accurate immediately postoperatively, regardless of potential sources of error, and is to be compared with measurement in the standing position versus radiological measurement on the AP pelvic survey. MATERIAL AND METHODS: The present retrospective study included 190 patients who had undergone primary total hip arthroplasty. The leg length difference (LLD) of the patients was determined pre- and postoperatively both in the supine and standing position and compared with the postoperative radiological pelvic survey image. RESULTS: Postoperatively, it was shown that the mean length measured was 0.35 mm too long in the supine position and 0.68 mm too short in the standing position (p value < 0.001). Determination of the average absolute measurement error produces a deviation of 4.06 mm in the standing and 4.51 mm in the supine position (p value 0.126). CONCLUSIONS: It is shown that the postoperative measurement of LLD in the supine and standing position is equally valid and sufficiently accurate, compared with the gold standard of measurement on a radiograph.

Chatbot-supported psychoeducation in adult attention-deficit hyperactivity disorder: randomised controlled trial.

BACKGROUND: Although psychoeducation is generally recommended for the treatment of adult attention-deficit hyperactivity disorder (ADHD), participation in clinical psychoeducation groups is impeded by waiting times and the constrained number of patients who can simultaneously attend a group. Digital psychoeducation attempts are promising, but the rapidly expanding number of apps lack evidence and are mostly limited to only a few implemented interactive elements. AIMS: To determine the potential of digital, self-guided psychoeducation for adult ADHD, a newly developed interactive chatbot was compared with a previously validated, conventional psychoeducation app. METHOD: Forty adults with ADHD were randomised, of whom 17 participants in each group completed self-guided psychoeducation based on either a chatbot or conventional psychoeducation app between October 2020 and July 2021. ADHD core symptoms were assessed before and after the 3-week interventions, using both the blinded observer-rated Integrated Diagnosis of ADHD in Adulthood interview and the self-rated ADHD Self-Assessment Scale (ADHS-SB). RESULTS: Observer- and patient-rated ADHD symptoms were significantly reduced from pre- to post-intervention (observer-rated: mean difference -6.18, 95% CI -8.06 to -4.29; patient-rated: mean difference -2.82, 95% CI -4.98 to -0.67). However, there were no group × intervention interaction effects that would indicate a stronger therapeutic benefit of one of the interventions. Likewise, administered psychoeducational knowledge quizzes did not show differences between the groups. No adverse events were reported. CONCLUSIONS: Self-guided psychoeducation based on a chatbot or a conventional app appears similarly effective and safe for improving ADHD core symptoms. Future research should compare additional control interventions and examine patient-related outcomes and usability preferences in detail.

Electrophysiological evidence for increased auditory crossmodal activity in adult ADHD.

Background: Attention deficit and hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by core symptoms of inattention, and/or impulsivity and hyperactivity. In order to understand the basis for this multifaceted disorder, the investigation of sensory processing aberrancies recently reaches more interest. For example, during the processing of auditory stimuli comparable low sensory thresholds account for symptoms like higher distractibility and auditory hypersensitivity in patients with ADHD. It has further been shown that deficiencies not only exist on an intramodal, but also on a multimodal level. There is evidence that the visual cortex shows more activation during a focused auditory task in adults with ADHD than in healthy controls. This crossmodal activation is interpreted as the reallocation of more attentional resources to the visual domain as well as deficient sensory inhibition. In this study, we used, for the first time, electroencephalography to identify a potential abnormal regulated crossmodal activation in adult ADHD. Methods: 15 adult subjects with clinically diagnosed ADHD and 14 healthy controls comparable in age and gender were included. ERP components P50, P100, N100, P200 and N200 were measured during the performance of a unimodal auditory and visual discrimination task in a block design. Sensory profiles and ADHD symptoms were assessed with inattention as well as childhood ADHD scores. For evaluating intramodal and crossmodal activations, we chose four EEG channels for statistical analysis and group-wise comparison. Results: At the occipital channel O2 that reflects possible crossmodal activations, a significantly enhanced P200 amplitude was measured in the patient group. At the intramodal channels, a significantly enhanced N200 amplitude was observed in the control group. Statistical analysis of behavioral data showed poorer performance of subjects with ADHD as well as higher discrimination thresholds. Further, the correlation of the assessed sensory profiles with the EEG parameters revealed a negative correlation between the P200 component and sensation seeking behavior. Conclusion: Our findings show increased auditory crossmodal activity that might reflect an altered stimulus processing resource allocation in ADHD. This might induce consequences for later, higher order attentional deployment. Further, the enhanced P200 amplitude might reflect more sensory registration and therefore deficient inhibition mechanisms in adults with ADHD.

Network-Based Differences in Top-Down Multisensory Integration between Adult ADHD and Healthy Controls-A Diffusion MRI Study.

BACKGROUND: Attention-deficit-hyperactivity disorder (ADHD) is a neurodevelopmental disorder neurobiologically conceptualized as a network disorder in white and gray matter. A relatively new branch in ADHD research is sensory processing. Here, altered sensory processing i.e., sensory hypersensitivity, is reported, especially in the auditory domain. However, our perception is driven by a complex interplay across different sensory modalities. Our brain is specialized in binding those different sensory modalities to a unified percept-a process called multisensory integration (MI) that is mediated through fronto-temporal and fronto-parietal networks. MI has been recently described to be impaired for complex stimuli in adult patients with ADHD. The current study relates MI in adult ADHD with diffusion-weighted imaging. Connectome-based and graph-theoretic analysis was applied to investigate a possible relationship between the ability to integrate multimodal input and network-based ADHD pathophysiology. METHODS: Multishell, high-angular resolution diffusion-weighted imaging was performed on twenty-five patients with ADHD (six females, age: 30.08 (SD: 9.3) years) and twenty-four healthy controls (nine females; age: 26.88 (SD: 6.3) years). Structural connectome was created and graph theory was applied to investigate ADHD pathophysiology. Additionally, MI scores, i.e., the percentage of successful multisensory integration derived from the McGurk paradigm, were groupwise correlated with the structural connectome. RESULTS: Structural connectivity was elevated in patients with ADHD in network hubs mirroring altered default-mode network activity typically reported for patients with ADHD. Compared to controls, MI was associated with higher connectivity in ADHD between Heschl's gyrus and auditory parabelt regions along with altered fronto-temporal network integrity. CONCLUSION: Alterations in structural network integrity in adult ADHD can be extended to multisensory behavior. MI and the respective network integration in ADHD might represent the maturational cortical delay that extends to adulthood with respect to sensory processing.

Prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among Substance Use Disorder (SUD) Populations: Meta-Analysis.

(1) Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of age-inappropriate levels of inattention and/or hyperactivity/impulsivity that results in functional impairment at work, education, or hobbies and affects family life, social contacts, and self-confidence. ADHD is a comorbid condition associated with a prognosis of severe substance use disorder (SUD) and the early onset of such. The aim of this meta-analysis was to obtain the best estimate of the prevalence of ADHD in SUD populations. (2) Methods: A literature research was conducted using PUBMED® and Web of Science®. The following search terms were used: [ADHD], [prevalence], and [substance use disorder]. RStudio® was used for meta-analysis methods. (3) Results: In total, 31 studies were included. We estimate the prevalence of ADHD among SUD patients at 21%.

Effects and feasibility of psychological interventions to reduce inattention symptoms in adults with ADHD: a systematic review.

BACKGROUND: Adult ADHD is common, highly comorbid, and restricts daily functioning. However, only a minority of patients receive appropriate treatment. AIMS: Primary objective: To identify psychological interventions that diminish inattention symptoms in adults with ADHD. Secondary objective: To evaluate feasibility aspects. METHODS: A search in PubMed, Cochrane Library, PsycInfo, PSYNDEX, and Eric was conducted. Interventions were grouped in: ADHD coaching, neuro feedback, cognitive training, psychoeducation, and behavioral therapy. Inattention symptoms were evaluated using standardized mean differences. Study quality was rated with the Cochrane Risk of Bias tool. Feasibility was assessed by number and time of sessions, setting, and qualification of the provider. RESULTS: A total of N = 2229 results were identified, 19 randomized controlled studies were included in the analysis. Behavioral therapy showed effects on inattention symptoms [SMD: 0.44-1.71] when compared to inactive controls. In terms of feasibility, longer interventions did not outperform shorter ones and individual sessions were not superior to group sessions. No effects were given for neuro feedback, cognitive training, and psychoeducation in comparison to controls. CONCLUSION: For adults with ADHD behavioral therapy seems an effective intervention to reduce inattention symptoms. In terms of feasibility, brief interventions may be valuable for a primary care setting.

Virtual reality in the diagnostic and therapy for mental disorders: A systematic review.

BACKGROUND: Virtual reality (VR) technologies are playing an increasingly important role in the diagnostics and treatment of mental disorders. OBJECTIVE: To systematically review the current evidence regarding the use of VR in the diagnostics and treatment of mental disorders. DATA SOURCE: Systematic literature searches via PubMed (last literature update: 9th of May 2022) were conducted for the following areas of psychopathology: Specific phobias, panic disorder and agoraphobia, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder, eating disorders, dementia disorders, attention-deficit/hyperactivity disorder, depression, autism spectrum disorder, schizophrenia spectrum disorders, and addiction disorders. ELIGIBILITY CRITERIA: To be eligible, studies had to be published in English, to be peer-reviewed, to report original research data, to be VR-related, and to deal with one of the above-mentioned areas of psychopathology. STUDY EVALUATION: For each study included, various study characteristics (including interventions and conditions, comparators, major outcomes and study designs) were retrieved and a risk of bias score was calculated based on predefined study quality criteria. RESULTS: Across all areas of psychopathology, k = 9315 studies were inspected, of which k = 721 studies met the eligibility criteria. From these studies, 43.97% were considered assessment-related, 55.48% therapy-related, and 0.55% were mixed. The highest research activity was found for VR exposure therapy in anxiety disorders, PTSD and addiction disorders, where the most convincing evidence was found, as well as for cognitive trainings in dementia and social skill trainings in autism spectrum disorder. CONCLUSION: While VR exposure therapy will likely find its way successively into regular patient care, there are also many other promising approaches, but most are not yet mature enough for clinical application. REVIEW REGISTRATION: PROSPERO register CRD42020188436. FUNDING: The review was funded by budgets from the University of Bonn. No third party funding was involved.

Smartphone-assisted psychoeducation in adult attention-deficit/hyperactivity disorder: A randomized controlled trial.

Psychoeducation is generally recommended in the treatment of adult Attention-Deficit/Hyperactivity Disorder (ADHD), but only few studies have systematically assessed the effects of structured clinical psychoeducation. Moreover, although a considerable number of psychoeducational mobile applications exist, none have provided scientific evidence for their effectiveness or safety. Therefore, the present randomized controlled trial investigated a newly developed, free-to-use psychoeducation app for adults with ADHD as a support to a clinical psychoeducation group. 236 adults with ADHD were contacted for study participation, of whom 60 were finally randomized to a psychoeducation group supported either by our developed smartphone app (n = 30) or by traditional pen-and-paper brochures (n = 30). Psychoeducation treatments were conducted in groups of 10, with 8 weekly one-hour sessions between March 2019 and November 2020. Observer-rated ADHD symptom severity (IDA-R interview) was examined as the primary outcome parameter before and after treatment. Across both interventions, ADHD core symptoms were significantly reduced. Notably, the smartphone-assisted psychoeducation was significantly more effective in improving inattention and impulsivity and led to higher homework compliance than the brochure-assisted psychoeducation. No adverse events were reported.

Robust perceptual-load-dependent audiovisual integration in adult ADHD.

We perceive our daily-life surrounded by different senses (e.g., visual, and auditory). For a coherent percept, our brain binds those multiple streams of sensory stimulations, i.e., multisensory integration (MI). Dependent on stimulus complexity, early MI is triggered by bottom-up or late via top-down attentional deployment. Adult attention-deficit/hyperactivity disorder (ADHD) is associated with successful bottom-up MI and deficient top-down MI. In the current study, we investigated the robustness of the bottom-up MI by adding additional task demand varying the perceptual load. We hypothesized diminished bottom-up MI for high perceptual load for patients with ADHD. 18 adult patients with ADHD and 18 age- and gender-matched healthy controls participated in this study. In the visual search paradigm, a target letter was surrounded by uniform distractors (low load) or by different letters (high load). Additionally, either unimodal (visual flash, auditory beep) or multimodal (audiovisual) flanked the visual search. Linear-mixed modeling was used to investigate the influence of load on reaction times. Further, the race model inequality was calculated. Patients with ADHD showed a similar degree of MI performance like healthy controls, irrespective of perceptual load manipulation. ADHD patients violated the race model for the low load but not for the high-load condition. There seems to be robust bottom-up MI independent of perceptual load in ADHD patients. However, the sensory accumulation might be altered when attentional demands are high.

The use of acetabular screws in total hip arthroplasty and its influence on wear and periacetabular osteolysis in the long-term follow-up.

PURPOSE: The cementless implantation of hip replacement cups may be performed with and without the additional use of acetabular screws. If the surgeon uses screws or not depends on variable factors. In general, the use of screws is intended to increase the primary stability of the cup. Whether screws increase the initial stability of the cup construct, or even reduce it in part, is the subject of considerable debate in the literature. It is also unclear whether the additional screws lead to increased wear or increased periacetabular osteolysis over the long-term course. METHODS: Two hundred eleven patients from a previous study with a minimum follow-up of 10.7 years were included. Of these, 68 patients with 82 total hip arthroplasties (THA) were given clinical and radiological follow-up examinations. Of these, 52 had been fitted without screws and 30 with screws. On the basis of radiographs, annual wear and osteolysis were quantified. The clinical results were recorded by means of VAS, HHS, and WOMAC scores. RESULTS: Significantly more periacetabular osteolysis was found if additive acetabular screws had been used. No difference was found in relation to the volumetric wear per year. Likewise, no difference was found with regard to the clinical scores. CONCLUSIONS: The use of additive acetabular screws leads to increased osteolysis in the periacetabular bone stock. Insofar as the primary stability of the cementless cup construct allows it, no additional acetabular screws should be used.

Disentangling early versus late audiovisual integration in adult ADHD: a combined behavioural and resting-state connectivity study.

BACKGROUND: Studies investigating sensory processing in attention-deficit/hyperactivity disorder (ADHD) have shown altered visual and auditory processing. However, evidence is lacking for audiovisual interplay - namely, multisensory integration. As well, neuronal dysregulation at rest (e.g., aberrant within- or between-network functional connectivity) may account for difficulties with integration across the senses in ADHD. We investigated whether sensory processing was altered at the multimodal level in adult ADHD and included resting-state functional connectivity to illustrate a possible overlap between deficient network connectivity and the ability to integrate stimuli. METHODS: We tested 25 patients with ADHD and 24 healthy controls using 2 illusionary paradigms: the sound-induced flash illusion and the McGurk illusion. We applied the Mann-Whitney U test to assess statistical differences between groups. We acquired resting-state functional MRIs on a 3.0 T Siemens magnetic resonance scanner, using a highly accelerated 3-dimensional echo planar imaging sequence. RESULTS: For the sound-induced flash illusion, susceptibility and reaction time were not different between the 2 groups. For the McGurk illusion, susceptibility was significantly lower for patients with ADHD, and reaction times were significantly longer. At a neuronal level, resting-state functional connectivity in the ADHD group was more highly regulated in polymodal regions that play a role in binding unimodal sensory inputs from different modalities and enabling sensory-to-cognition integration. LIMITATIONS: We did not explicitly screen for autism spectrum disorder, which has high rates of comorbidity with ADHD and also involves impairments in multisensory integration. Although the patients were carefully screened by our outpatient department, we could not rule out the possibility of autism spectrum disorder in some participants. CONCLUSION: Unimodal hypersensitivity seems to have no influence on the integration of basal stimuli, but it might have negative consequences for the multisensory integration of complex stimuli. This finding was supported by observations of higher resting-state functional connectivity between unimodal sensory areas and polymodal multisensory integration convergence zones for complex stimuli.

Disentangling ADHD's Presentation-Related Decision-Making-A Meta-Analytic Approach on Predominant Presentations.

Background: Deficient decision-making (DM) in attention deficit/hyperactivity disorder (ADHD) is marked by altered reward sensitivity, higher risk taking, and aberrant reinforcement learning. Previous meta-analysis aggregate findings for the ADHD combined presentation (ADHD-C) mostly, while the ADHD predominantly inattentive presentation (ADHD-I) and the predominantly hyperactive/impulsive presentation (ADHD-H) were not disentangled. The objectives of the current meta-analysis were to aggregate findings from DM for each presentation separately. Methods: A comprehensive literature search of the PubMed (Medline) and Web of Science Database took place using the keywords "ADHD," "attention-deficit/hyperactivity disorder," "decision-making," "risk-taking," "reinforcement learning," and "risky." Random-effects models based on correlational effect-sizes were conducted. Heterogeneity analysis and sensitivity/outlier analysis were performed, and publication biases were assessed with funnel-plots and the egger intercept. Results: Of 1,240 candidate articles, seven fulfilled criteria for analysis of ADHD-C (N = 193), seven for ADHD-I (N = 256), and eight for ADHD-H (N = 231). Moderate effect-size were found for ADHD-C (r = 0.34; p = 0.0001; 95% CI = [0.19, 0.49]). Small effect-sizes were found for ADHD-I (r = 0.09; p = 0.0001; 95% CI = [0.008, 0.25]) and for ADHD-H (r = 0.1; p = 0.0001; 95% CI = [-0.012, 0.32]). Heterogeneity was moderate for ADHD-H. Sensitivity analyses show robustness of the analysis, and no outliers were detected. No publication bias was evident. Conclusion: This is the first study that uses a meta-analytic approach to investigate the relationship between the different presentations of ADHD separately. These findings provide first evidence of lesser pronounced impairment in DM for ADHD-I and ADHD-I compared to ADHD-C. While the exact factors remain elusive, the current study can be considered as a starting point to reveal the relationship of ADHD presentations and DM more detailed.

Development and validation of an emotional picture set of self-injury (EPSI) for borderline personality disorder: protocol for a validation study.

INTRODUCTION: Borderline personality disorder (BPD) is a severe psychiatric disorder that is characterised by major problems in emotion regulation. Affected persons frequently engage in non-suicidal self-injury (NSSI) to regulate emotions. NSSI is associated with high emotionality in patients with BPD and it can be expected that stimuli depicting scenes of NSSI elicit an emotional response indicative of BPD. The present study protocol describes the development and validation of an emotional picture set of self-injury (EPSI) to advance future research on emotion regulation in BPD. METHODS AND ANALYSIS: The present validation study aims to develop and validate an emotional picture set relevant for BPD. Emotional responses to EPSI as well as to a neutral picture set will be investigated in a sample of 30 patients with BPD compared with 30 matched, healthy controls and to 30 matched depressive controls. Emotional responses will be assessed by heart rate variability, facial expression and Self-Assessment Manikin. ETHICS AND DISSEMINATION: Ethics approval was obtained by the medical ethics committee of the Carl-von-Ossietzky University of Oldenburg, Germany (registration: 2017-044). The results of the trial will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT03149926; Pre-results.

Hyperactivity/restlessness is associated with increased functional connectivity in adults with ADHD: a dimensional analysis of resting state fMRI.

BACKGROUND: Adult attention-deficit/hyperactivity disorder (ADHD) is a serious and frequent psychiatric disorder of multifactorial pathogenesis. Several lines of evidence support the idea that ADHD is, in its core, a disorder of dysfunctional brain connectivity within and between several neurofunctional networks. The primary aim of this study was to investigate associations between the functional connectivity within resting state brain networks and the individual severity of core ADHD symptoms (inattention, hyperactivity, and impulsivity). METHODS: Resting state functional magnetic resonance imaging (rs-fMRI) data of 38 methylphenidate-naïve adults with childhood-onset ADHD (20 women, mean age 40.5 years) were analyzed using independent component analysis (FSL's MELODIC) and FSL's dual regression technique. For motion correction, standard volume-realignment followed by independent component analysis-based automatic removal of motion artifacts (FSL's ICA-AROMA) were employed. To identify well-established brain networks, the independent components found in the ADHD group were correlated with brain networks previously found in healthy participants (Smith et al. PNAS 2009;106:13040-5). To investigate associations between functional connectivity and individual symptom severity, sex, and age, linear regressions were performed. RESULTS: Decomposition of resting state brain activity of adults with ADHD resulted in similar resting state networks as previously described for healthy adults. No significant differences in functional connectivity were seen between women and men. Advanced age was associated with decreased functional connectivity in parts of the bilateral cingulate and paracingulate cortex within the executive control network. More severe hyperactivity was associated with increased functional connectivity in the left putamen, right caudate nucleus, right central operculum and a portion of the right postcentral gyrus within the auditory/sensorimotor network. CONCLUSIONS: The present study supports and extends our knowledge on the involvement of the striatum in the pathophysiology of ADHD, in particular, in the pathogenesis of hyperactivity. Our results emphasize the usefulness of dimensional analyses in the study of ADHD, a highly heterogeneous disorder. TRIAL REGISTRATION: ISRCTN12722296 ( https://doi.org/10.1186/ISRCTN12722296 ).

Impact of bariatric surgery on neural food processing and cognition: an fMRI study.

INTRODUCTION: The Roux-en-Y gastric bypass (RYGB) is one of the most widely used techniques for bariatric surgery. After RYGB, weight loss up to 50%-70% of excess body weight, improvement of insulin-resistance, changes in food preferences and improvements in cognitive performance have been reported. This protocol describes a longitudinal study of the neural correlates associated with food-processing and cognitive performance in patients with morbid obesity before and after RYGB relative to lean controls. METHODS AND ANALYSIS: This study is a pre-post case-control experiment. Using functional MRI, the neural responses to food stimuli and a working memory task will be compared between 25 patients with obesity, pre and post RYGB, and a matched, lean control group. Resting state fMRI will be measured to investigate functional brain connectivity. Baseline measurements for both groups will take place 4 weeks prior to RYGB and 12 months after RYGB. The effects of RYGB on peptide tyrosine tyrosine and glucagon-like polypeptide-1 will also be determined. ETHICS AND DISSEMINATION: The project has received ethical approval by the local medical ethics committee of the Carl-von-Ossietzky University of Oldenburg, Germany (registration: 2017-073). Results will be published in a peer-reviewed journal as original research and on international conferences. TRIAL REGISTRATION NUMBER: DRKS00012495; Pre-results.

Durability of stochastic antireflective structures--analyses on damage thresholds and adsorbate elimination.

We fabricated stochastic antireflective structures (ARS) and analyzed their stability against high power laser irradiation and high temperature annealing. For 8 ps pulse duration and 1030 nm wavelength we experimentally determined their laser induced damage threshold to 4.9 (±0.3) J/cm(2), which is nearly as high as bulk fused silica with 5.6 (±0.3) J/cm(2). A commercial layer stack reached 2.0 (±0.2) J/cm(2). An annealing process removed adsorbed organics, as shown by XPS measurements, and significantly increased the transmission of the ARS. Because of their monolithic build the ARS endure such high temperature treatments. For more sensitive samples an UV irradiation proved to be capable. It decreased the absorbed light and reinforced the transmission.

Antireflective subwavelength structures on microlens arrays-comparison of various manufacturing techniques.

Antireflective subwavelength structures (ARS) resembling nanostructures found on the cornea of night-active insects reduce the reflection of light by providing a gradual change in the refractive index at the interface. These artificial ARS have mainly been fabricated by a combination of conventional lithography and reactive ion etching, which constrains their application to planar substrates. We report on the fabrication of ARS using three different techniques including bottom-up and top-down methods as well as their combination on microlens arrays (MLAs) made of fused silica. The optical performance of the resulting ARS on the MLAs is as good as ARS fabricated on planar substrates with increased transmission of up to 96% at certain wavelengths.

Poly(ethylene glycol)-coated microfluidic devices for chip electrophoresis.

Herein, we report on a strategy for durable modification of the channel surface in microfluidic glass chips with the neutral hydrophilic-coating material poly(ethylene glycol) PEG-1M-100. Applied in microchip electrophoresis such PEG-coated devices exhibit a suppressed electroosmotic flow and reduced analyte adsorption. The PEG-coated chips were successfully applied in chip electrophoresis of FITC-labelled amines and amino acids and native proteins as well as in chiral separations. The performance of the coated chips was found to be superior compared with uncoated microchips. The coated chips exhibited high stability and the relative standard deviation of migration times in PEG-coated devices was less than 2%.