Different autism measures targeting different severity levels in children with autism spectrum disorder.

The Childhood Autism Rating Scale™, Second Edition (CARS™-2) and Social Responsiveness Scale™, Second Edition (SRS™-2) are two measures for identifying autism symptoms. The CARS™-2 has two versions: Standard (CARS-ST) and High-Functioning (CARS-HF). To better understand their properties, this study aimed to investigate: (1) the associations among the CARS-ST, CARS-HF and the SRS™-2, and (2) the severity consistency between the CARS-ST and the CARS-HF. A sample of 125 children with autism spectrum disorder was recruited (mean age: 80.98 months, SD = 16.08). Based on Verbal Comprehension Index (VCI), children were divided into two groups: low severity level of autism spectrum disorder (LSL-ASD: VCI ≥ 80) and high severity level of autism spectrum disorder (HSL-ASD: VCI < 80). All children were evaluated with the CARS-ST and the SRS™-2, and the HF group, with the CARS-HF as well. In the LSL group, the CARS-ST and the CARS-HF had high correlation (r = 0.852, p < .001). Both versions had small to moderate correlations with the SRS™-2 (r = 0.130-0.491). In the HSL group, no significant correlations were found between the CARS-ST and SRS™-2 (p > .05). The CARS-HF and the CARS-ST had low severity consistency (Kappa = 0.376, p < .01). The CARS-ST and the CARS-HF had high correlations but low severity consistency. Different correlation patterns were found between the CARS™-2 and the SRS™-2 in the LSL and HSL groups. The results should help clinicians better understand the properties of the measures and choose appropriate measures when assessing autism symptoms.

Omega-3 Polyunsaturated Fatty Acids for Core Symptoms of Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis of Randomized Controlled Trials.

Objective: Previous studies have shown conflicting results for the effectiveness of omega-3 polyunsaturated fatty acids (PUFAs) in improving attention-deficit/hyperactivity disorder (ADHD) symptoms. This inconsistency may be due to differences in dosage, composition, and treatment duration. The current meta-analysis aims to address this inconsistency by improving subtype analyses and focusing on heterogeneity in treatment duration, omega-3 PUFA composition, and eicosapentaenoic acid (EPA) dose.Data Sources and Study Selection: We searched PubMed, EMBASE, PsycINFO, and Cochrane Library for randomized controlled trials of omega-3 PUFAs for ADHD, without publication year or language limitations, up to November 27, 2022. The primary outcome was the improvement of ADHD core symptoms. Subgroup analyses were conducted based on the formula, dosages, and composition ratios of omega-3 PUFAs. To ensure methodological quality, the Cochrane Risk-of-Bias Tool 1.0 was utilized to assess the risk of bias for each study included in the analysis. The pooled data were then analyzed using the random-effect meta-analysis, and the inverse variance method was employed.Data Extraction: The outcomes of interest were extracted using a data extraction form developed for this study.Results: Twenty-two studies with 1,789 participants were included in the analysis. Overall, omega-3 PUFAs did not significantly improve ADHD core symptoms compared to placebo (standardized mean difference [SMD]: -0.16; 95% CI, -0.34 to 0.01; P = .07). However, in the subgroup of studies with a treatment duration of at least 4 months, omega-3 PUFAs were significantly more effective than placebo (SMD: -0.35; 95% CI,-0.61 to -0.09; P = .007). Neither high eicosapentaenoic acid (EPA) dosage nor high EPA/docosahexaenoic acid (DHA) ratio was found to improve ADHD symptoms.Conclusions: Our findings indicate that omega-3 PUFAs did not improve ADHD core symptoms, but long-term supplementation may have potential benefits. The main limitation of the study was the moderate heterogeneity and small sample sizes in subgroup analyses and the lack of dietary pattern information.

Limbic Connectivity Underlies Pain Treatment Response in Small-Fiber Neuropathy.

OBJECTIVE: Small-fiber neuropathy (SFN) is characterized by neuropathic pain due to degeneration of small-diameter nerves in the skin. Given that brain reorganization occurs following chronic neuropathic pain, this study investigated the structural and functional basis of pain-related brain changes after skin nerve degeneration. METHODS: Diffusion-weighted and resting-state functional MRI data were acquired from 53 pathologically confirmed SFN patients, and the structural and functional connectivity of the pain-related network was assessed using network-based statistic (NBS) analysis. RESULTS: Compared with age- and sex-matched controls, the SFN patients exhibited a robust and global reduction of functional connectivity, mainly across the limbic and somatosensory systems. Furthermore, lower functional connectivity was associated with skin nerve degeneration measured by reduced intraepidermal nerve fiber density and better therapeutic response to anti-neuralgia medications, particularly for the connectivity between the insula and the limbic areas including the anterior and middle cingulate cortices. Similar to the patterns of functional connectivity changes, the structural connectivity was robustly reduced among the limbic and somatosensory areas, and the cognition-integration areas including the inferior parietal lobule. There was shared reduction of structural and functional connectivity among the limbic, somatosensory, striatal, and cognition-integration systems: (1) between the middle cingulate cortex and inferior parietal lobule and (2) between the thalamus and putamen. These observations indicate the structural basis underlying altered functional connectivity in SFN. INTERPRETATION: Our findings provide imaging evidence linking structural and functional brain dysconnectivity to sensory deafferentation caused by peripheral nerve degeneration and therapeutic responses for neuropathic pain in SFN. ANN NEUROL 2023;93:655-667.

Using the alluvial plot to visualize the network characteristics of 100 top-cited articles on attention-deficit/hyperactivity disorder (ADHD) since 2011: Bibliometric analysis.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common neuro developmental disorder that affects children and adolescents. It is estimated that the prevalence of ADHD is 7.2% throughout the world. There have been a number of articles published in the literature related to ADHD. However, it remains unclear which countries, journals, subject categories, and articles have the greatest influence. The purpose of this study was to display influential entities in 100 top-cited ADHD-related articles (T100ADHD) on an alluvial plot and apply alluvial to better understand the network characteristics of T100ADHD across entities. METHODS: Using the PubMed and Web of Science (WoS) databases, T100ADHD data since 2011 were downloaded. The dominant entities were compared using alluvial plots based on citation analysis. Based on medical subject headings (MeSH terms) and research areas extracted from PubMed and WoS, social network analysis (SNA) was performed to classify subject categories. To examine the difference in article citations among subject categories and the predictive power of MeSH terms on article citations in T100ADHD, one-way analysis of variance and regression analysis were used. RESULTS: The top 3 countries (the United States, the United Kingdom, and the Netherlands) accounted for 75% of T100ADHD. The most citations per article were earned by Brazil (=415.33). The overall impact factor (IF = citations per 100) of the T100ADHD series is 188.24. The most cited article was written by Polanczyk et al from Brazil, with 772 citations since 2014. The majority of the articles were published and cited in Biol Psychiatry (13%; IF = 174.15). The SNA was used to categorize 6 subject areas. On the alluvial plots, T100ADHD's network characteristics were successfully displayed. There was no difference in article citations among subject categories (F = 1.19, P = .320). The most frequently occurring MeSH terms were physiopathology, diagnosis, and epidemiology. A significant correlation was observed between MeSH terms and the number of article citations (F = 25.36; P < .001). CONCLUSION: Drawing the alluvial plot to display network characteristics in T100ADHD was a breakthrough. Article subject categories can be classified using MeSH terms to predict T100ADHD citations. Bibliometric analyses of 100 top-cited articles can be conducted in the future.

Different mediators of applied theory-of-mind competence in children with autism spectrum disorder.

BACKGROUND: Children with autistic spectrum disorder (ASD) with mild and moderate symptom levels have significant differences in applied theory of mind (ToM) competence. However, their mediators of applied ToM competence have not been documented. AIMS: This study aimed to identify the mediators of applied ToM competence in these two clinically distinct groups. METHODS: A total of 163 children with ASD aged 3-12 years old (88 and 75 children respectively in the mild and moderate groups) and their caregivers participated in this study. Data of children's verbal comprehension, explicit ToM knowledge and applied ToM competence were collected and then analyzed using mediation analysis. RESULTS: The results of mediation analysis showed that verbal comprehension (95% confidence interval [CI] of indirect effect: 0.02 - 0.19) and explicit ToM knowledge (95% CI of indirect effect: 0.01 - 0.07) were the mediators of applied ToM competence in children with mild and those with moderate symptoms, respectively. CONCLUSIONS AND IMPLICATIONS: Our findings demonstrate that the mediators of applied ToM competence differ by symptom level in children with ASD. Applied ToM competence and the mediators should be assessed for designing tailored and effective intervention plans for these children according to their symptom level.

Impaired brain network architecture as neuroimaging evidence of pain in diabetic neuropathy.

AIMS: To investigate alterations in structural brain networks due to chronic diabetic neuropathic pain. METHODS: The current study recruited 24 patients with painful diabetic neuropathy (PDN) to investigate the influences of chronic pain on the brain. Thirteen patients with painless diabetic neuropathy (PLDN) and 24 healthy adults were recruited as disease and healthy controls. White matter connectivity of the brain networks constructed by diffusion tractography was compared across groups using the Network-based statistic (NBS) method. Graph theoretical analysis was further applied to assess topological changes of the brain networks. RESULTS: The PDN patients had a significant reduction in white matter connectivity compared with PLDN and controls in the limbic and temporal regions, particularly the insula, hippocampus and parahippocampus, the amygdala, and the middle temporal gyrus. The PDN patients also exhibited an altered topology of the brain networks with reduced global efficiency and betweenness centrality. CONCLUSION: The current findings indicate that topological alterations of brain networks may serve as a biomarker for pain-induced maladaptive reorganization of the brain in PDN. Given the high prevalence of diabetes worldwide, novel insights from network sciences to investigate the central mechanisms of diabetic neuropathic pain are warranted.

Effects of harassment on psychological inflexibility/experiential avoidance among Taiwanese emergent adult gay and bisexual men.

BACKGROUND/PURPOSE: Gay and bisexual men are at a higher risk of mental and physical health problems than heterosexual men, reporting higher frequencies of harassment and discrimination in both housing and employment domains. Psychological inflexibility/experiential avoidance (PI/EA) refers to behaviors that are rigidly guided by psychological reactions rather than direct contingencies or personal values; PI/EA referring to a key psychopathology behavior related to greater mental illness. The objective of the study was to examine the association of various types of harassment with PI/EA and the effects of multiple types and site harassment on PI/EA among Taiwanese emergent adult gay and bisexual men. METHODS: A total of 305 gay and bisexual men aged between 20 and 25 years were recruited into this study. The level of PI/EA and types of harassment were evaluated and further analysis the effect of harassment on PI/EA. RESULTS: Findings indicated that various types of harassment exerted significant effects on PI/EA in emergent adult gay and bisexual men; furthermore, the effect was cumulative. The result also revealed that victims of verbal ridicule and relational exclusion, victims of physical aggression and theft of belongings, and victims of cyber harassment had significantly higher PI/EA. CONCLUSION: Harassment experiences appeared to be significantly associated with PI/EA, and the effects could be cumulative. It would be beneficial to construct a friendly world for emergent adult gay and bisexual men. Evaluation and intervention with PI/EA improvement should be considered for emergent adult gay and bisexual men with traditional and cyber harassment experiences.

Brain Mechanisms of Pain and Dysautonomia in Diabetic Neuropathy: Connectivity Changes in Thalamus and Hypothalamus.

CONTEXT: About one-third of diabetic patients suffer from neuropathic pain, which is poorly responsive to analgesic therapy and associated with greater autonomic dysfunction. Previous research on diabetic neuropathy mainly links pain and autonomic dysfunction to peripheral nerve degeneration resulting from systemic metabolic disturbances, but maladaptive plasticity in the central pain and autonomic systems following peripheral nerve injury has been relatively ignored. OBJECTIVE: This study aimed to investigate how the brain is affected in painful diabetic neuropathy (PDN), in terms of altered structural connectivity (SC) of the thalamus and hypothalamus that are key regions modulating nociceptive and autonomic responses. METHODS: We recruited 25 PDN and 13 painless (PLDN) diabetic neuropathy patients, and 27 healthy adults as controls. The SC of the thalamus and hypothalamus with limbic regions mediating nociceptive and autonomic responses was assessed using diffusion tractography. RESULTS: The PDN patients had significantly lower thalamic and hypothalamic SC of the right amygdala compared with the PLDN and control groups. In addition, lower thalamic SC of the insula was associated with more severe peripheral nerve degeneration, and lower hypothalamic SC of the anterior cingulate cortex was associated with greater autonomic dysfunction manifested by decreased heart rate variability. CONCLUSION: Our findings indicate that alterations in brain structural connectivity could be a form of maladaptive plasticity after peripheral nerve injury, and also demonstrate a pathophysiological association between disconnection of the limbic circuitry and pain and autonomic dysfunction in diabetes.

Predicting the number of article citations in the field of attention-deficit/hyperactivity disorder (ADHD) with the 100 top-cited articles since 2014: a bibliometric analysis.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children or early adolescents with an estimated worldwide prevalence of 7.2%. Numerous articles related to ADHD have been published in the literature. However, which articles had ultimate influence is still unknown, and what factors affect the number of article citations remains unclear as well. This bibliometric analysis (1) visualizes the prominent entities with 1 picture using the top 100 most-cited articles, and (2) investigates whether medical subject headings (i.e., MeSH terms) can be used in predicting article citations. METHODS: By searching the PubMed Central® (PMC) database, the top 100 most-cited abstracts relevant to ADHD since 2014 were downloaded. Citation rank analysis was performed to compare the dominant roles of article types and topic categories using the pyramid plot. Social network analysis (SNA) was performed to highlight prominent entities for providing a quick look at the study result. The authors examined the MeSH prediction effect on article citations using its correlation coefficients (CC). RESULTS: The most frequent article types and topic categories were research support by institutes (56%) and epidemiology (28%). The most productive countries were the United States (42%), followed by the United Kingdom (13%), Germany (9%), and the Netherlands (9%). Most articles were published in the Journal of the American Academy of Child and Adolescent Psychiatry (15%) and JAMA Psychiatry (9%). MeSH terms were evident in prediction power on the number of article citations (correlation coefficient = 0.39; t = 4.1; n = 94; 6 articles were excluded because they do not have MeSH terms). CONCLUSIONS: The breakthrough was made by developing 1 dashboard to display 100 top-cited articles on ADHD. MeSH terms can be used in predicting article citations on ADHD. These visualizations of the top 100 most-cited articles could be applied to future academic pursuits and other academic disciplines.

Cool Executive Function and Verbal Comprehension Mediate the Relation of Hot Executive Function and Theory of Mind in Children with Autism Spectrum Disorder.

Impaired executive function (EF), verbal comprehension, and theory of mind (ToM) may contribute to social difficulties in children with autism spectrum disorder (ASD). The linkage between cool (cognitive) EF and ToM has been widely investigated, but the relations between hot (affective) EF and ToM remain largely unknown. The roles of cool EF and verbal comprehension have not been previously explored together to address hot EF-ToM relations. This study applied mediation analysis to investigate the mediating effects of cool EF and verbal comprehension to further elaborate the link between hot EF and ToM in children with ASD and average intellectual abilities. A total of 97 children with ASD aged from 6 to 12 years participated in this study. Children's cool EF, hot EF, and verbal comprehension were, respectively, measured with the computerized Dimensional Change Card Sort task, Children's Gambling Task, and the verbal comprehension index of the Wechsler Intelligence Scale for Children-fourth edition. Children's ToM was assessed with the Theory of Mind Task Battery. Partial correlation coefficients indicated that hot EF was significantly related with ToM with age controlled for. The results of the mediation analysis showed that cool EF and verbal comprehension mediated the linkage between hot EF and ToM. These findings highlight not only the connections between hot EF and ToM but also the importance of cool EF and verbal comprehension on hot EF-ToM relations in clinical assessments and interventions for school-aged children with ASD and average intellectual abilities. LAY SUMMARY: Relatively few studies have investigated the hot (affective) executive function (EF)-theory of mind (ToM) relations in children with autism spectrum disorder (ASD). This study discovered that hot EF was significantly related to ToM, while cool (cognitive) EF and verbal comprehension mediated the relationship between hot EF and ToM. Therefore, the influence of cool EF and verbal comprehension on hot EF-ToM relations should be considered in studies involving children with ASD. Autism Res 2021, 14: 921-931. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

Brain imaging signature of neuropathic pain phenotypes in small-fiber neuropathy: altered thalamic connectome and its associations with skin nerve degeneration.

ABSTRACT: Small-fiber neuropathy (SFN) has been traditionally considered as a pure disorder of the peripheral nervous system, characterized by neuropathic pain and degeneration of small-diameter nerve fibers in the skin. Previous functional magnetic resonance imaging studies revealed abnormal activations of pain networks, but the structural basis underlying such maladaptive functional alterations remains elusive. We applied diffusion tensor imaging to explore the influences of SFN on brain microstructures. Forty-one patients with pathology-proven SFN with reduced skin innervation were recruited. White matter connectivity with the thalamus as the seed was assessed using probabilistic tractography of diffusion tensor imaging. Patients with SFN had reduced thalamic connectivity with the insular cortex and the sensorimotor areas, including the postcentral and precentral gyri. Furthermore, the degree of skin nerve degeneration, measured by intraepidermal nerve fiber density, was associated with the reduction of connectivity between the thalamus and pain-related areas according to different neuropathic pain phenotypes, specifically, the frontal, cingulate, motor, and limbic areas for burning, electrical shocks, tingling, mechanical allodynia, and numbness. Despite altered white matter connectivity, there was no change in white matter integrity assessed with fractional anisotropy. Our findings indicate that alterations in structural connectivity may serve as a biomarker of maladaptive brain plasticity that contributes to neuropathic pain after peripheral nerve degeneration.

Online Food Shopping: A Conceptual Analysis for Research Propositions.

Shopping foods online is different from shopping other things online. To stimulate more thinking and enrich potential future research imagination, this paper reviews for online food shopping features, offers a commentary, and proposes future research directions. The propositions include the following: (1) The design and implementation of online food shopping (eco)systems should engage the consumers and other stakeholders to co-create collective and social values; (2) A better fit between technologies' and food businesses' natures could generate better applications for online food shopping; (3) A business model with sound finance systems becomes the core of a healthy online food ecosystem; (4) The interaction and transformation between online (virtual) and offline (virtual) food businesses determines the dynamic development of future food shopping.

Using the Kano model to display the most cited authors and affiliated countries in schizophrenia research.

In order to improve individual research achievements (IRA), this study investigates which affiliated countries and authors earn the most cited IRAs and whether those types of articles are associated with the number of cited papers on schizophrenia from a leading journal in the field. The Kano model was used for displaying the IRAs. Clusters of medical subject headings (MeSH) were applied to explore the core concepts of a given journal. This study aimed to apply social network analysis (SNA) and an authorship-weighted scheme (AWS) to inspect the association between MeSH terms and IRA. About 2,008 abstracts published between 2012 and 2016 in the journal Schizophrenia Research were downloaded from Pubmed Central using the keyword (Schizophr Res)[Journal] on September 20, 2018. The MeSH terms were clustered by using SNA to separate the core concepts and compare the differences in bibliometric indices (i.e., h, Ag, x and author impact factor or AIF). Visual dashboards were shown on Google Maps. Results indicate that (1) the US, the UK, and Canada earn the highest x-index; (2) the top one author from the US has the highest x-index (= 5.73 with x-core at cited = 16.44 and citable = 2); (3) the article type of schizophrenic psychology shows distinctly higher frequencies than others; and (4) article types are associated with the number of cited papers. Four approaches of the Kano model, SNA, MeSH terms, and AWS can be accommodated to display IRAs, classify article types, and quantify coauthor contributions in the article byline, respectively, and applied to other scientific disciplines in the future, not just in this specific journal.

Negative Facebook experiences among Taiwanese gay and bisexual men in emerging adulthood: associations with traditional harassment victimization and quality of life.

Purpose: To examine the prevalence of negative Facebook (FB) experiences among gay and bisexual men in emerging adulthood in Taiwan and their association with traditional harassment victimization and quality of life (QOL). Materials and methods: In total, 302 gay or bisexual men aged 20-25 years old with experience of FB use in the preceding year were recruited. We measured the types, severities, and prevalence of negative FB experiences by self-report questionnaires. Traditional harassment victimization experiences were assessed using the adapted form of Chinese-version School Bullying Experience Questionnaire (C-SBEQ). QOL was evaluated by The World Health Organization (WHO) Questionnaire on Quality of Life: Short Form (WHOQOL-BREF). Regression analysis was used to assess respective associations. Results: Among the study participants, 26.5% reported having negative FB experiences in the preceding year. Negative FB experiences were significantly associated with victimization of verbal ridicule and relational exclusion, but not physical aggression or theft of belongings. Negative FB experiences were also significantly associated with unsatisfactory QOL in all domains except social relationships, even the effects of traditional bullying victimization were controlled. Conclusion: Negative FB experiences are closely associated with both real life victimization and QOL in gay and bisexual men. Subjective experiences on social networking sites require consideration in conception of measures to reduce bullying victimization as well as improve QOL in this population.

Association Between Executing Theory of Mind in a Limited Experimental Context and Executing It in Daily Contexts in Children With Autism Spectrum Disorder: A Cross-Sectional Study.

IMPORTANCE: Theory of mind (ToM) can be divided into two constructs: capacity and performance. Although severity of autism traits and verbal comprehension have been identified as being associated with ToM capacity, no study has yet verified their role in predicting the ToM performance of children with autism spectrum disorder (ASD). OBJECTIVE: To examine the differences and associations between ToM capacity and ToM performance and to verify the role of autism traits and verbal comprehension in predicting ToM performance in children with ASD. DESIGN: Cross-sectional study. SETTING: Pediatric rehabilitation hospitals and clinics. PARTICIPANTS: One hundred four children with ASD who met the inclusion criteria. OUTCOMES AND MEASURES: We examined ToM capacity and ToM performance with the Theory of Mind Task Battery (ToMTB) and the Theory of Mind Inventory-2-Chinese version (ToMI-2-C). Severity of autism traits and verbal comprehension were assessed with the Social Responsiveness Scale, Second Edition (SRS-2), and the Verbal Comprehension Index (VCI) of either the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition or the Wechsler Intelligence Scale for Children-Fourth Edition. We conducted correlation and hierarchical regression analyses. RESULTS: Scores on the ToMI-2-C were significantly correlated with those on the ToMTB, SRS-2, and VCI (rs = .613, -.344, and .566, respectively; p < .01). CONCLUSIONS AND RELEVANCE: ToM capacity is significantly correlated with ToM performance. Both severity of autism traits and verbal comprehension played an important role in predicting ToM performance of children with ASD after controlling for ToM capacity. WHAT THIS ARTICLE ADDS: ToM capacity, severity of autism traits, and verbal comprehension were all significant predictors of ToM performance. Improving ToM capacity, severity of autism traits, and verbal comprehension of children with ASD would be beneficial to their ToM performance.

Prediction Of Playfulness By Pretend Play, Severity Of Autism Behaviors, And Verbal Comprehension In Children With Autism Spectrum Disorder.

BACKGROUND: Children with autism spectrum disorder (ASD) often exhibit deficits in pretend play and have less playfulness. The purpose of this study was to evaluate the relationship between pretend play and playfulness in children with autism spectrum disorder, while controlling for severity of autism behaviors, verbal comprehension, and age. METHODS: A sample of 72 children with ASD aged between 3 and 12 years were assessed with the Child-Initiated Pretend Play Assessment, Test of Playfulness, and Childhood Autism Rating Scale, respectively, for their pretend play, playfulness, and severity of autism behaviors. Correlation and multiple regression analyses were conducted. RESULTS: The results of Pearson correlation coefficients revealed that the pretend play variables had mild to moderate associations with the playfulness variables (r = -0.25 to 0.68). The multiple regression analyses showed that, overall, the internal locus of control was the significant predictor of the pretend play variables (accounting for 5-47% of the variance, p < 0.001). The six pretend play variables were all important predictors of all playfulness variables (explaining 41-76% of the variance, p < 0.001-0.047). Particularly, the elaborate pretend play action was a significant predictor of all four playfulness variables. Our findings indicated that the more children with ASD engaged in pretend play, the more they experienced playfulness. CONCLUSION: Clinicians could help children with ASD improve their feeling of being in charge of their play in order to develop better performance in pretend play. Assisting children with ASD to engage in pretend play is important to promote their internal experience of playfulness.

Social adjustment and family function after drug switch from IR-methylphenidate to OROS-methylphenidate in patients with attention-deficit/hyperactivity disorder.

PURPOSE: This prospective, single-arm, open-label, 8-week, multicenter study investigated the effectiveness of switching from immediate-release methylphenidate (IR-MPH) to osmotic controlled-release methylphenidate (OROS-MPH) in patients with attention-deficit/hyperactivity disorder (ADHD). PATIENTS AND METHODS: Overall, 296 patients with ADHD (mean age: 9.5 years) already on IR-MPH treatment were enrolled. Upon enrollment, a flexible dose of OROS-MPH was administered, replacing IR-MPH. Patients were assessed at baseline and weeks 2, 4, and 8 using the Swanson, Nolan, and Pelham version IV scale (SNAP-IV) and the Clinical Global Impression for ADHD symptoms. The Social Adjustment Inventory for Children and Adolescents assessed social functions, and the Chinese Health Questionnaire (CHQ) and Family Adaptation, Partnership, Growth, Affection, and Resolve evaluated parental and family functions. RESULTS: Switching from IR-MPH to OROS-MPH yielded significant improvements in all ADHD symptoms, as rated by parents, teachers (SNAP-IV), and study investigators (Clinical Global Impression). CHQ scores and all Social Adjustment Inventory for Children and Adolescents subscores except spare time scores improved significantly. Patients with poor IR-MPH adherence had greater improvements in teacher-rated SNAP-IV and mothers' mental health (CHQ) after switching. CONCLUSION: Switching from IR-MPH to OROS-MPH improved patients' behavioral ADHD symptoms and social adjustment, and mental health of patients' mothers. This was most evident in patients who previously exhibited poor IR-MPH adherence.

Contextual interference enhances motor learning through increased resting brain connectivity during memory consolidation.

Increasing contextual interference (CI) during practice benefits learning, making it a desirable difficulty. For example, interleaved practice (IP) of motor sequences is generally more difficult than repetitive practice (RP) during practice but leads to better learning. Here we investigated whether CI in practice modulated resting-state functional connectivity during consolidation. 26 healthy adults (11 men/15 women, age = 23.3 ±â€¯1.3 years) practiced two sets of three sequences in an IP or RP condition over 2 days, followed by a retention test on Day 5 to evaluate learning. On each practice day, functional magnetic resonance imaging (fMRI) data were acquired during practice and also in a resting state immediately after practice. The resting-state fMRI data were processed using independent component analysis (ICA) followed by functional connectivity analysis, showing that IP on Day 1 led to greater resting connectivity than RP between the left premotor cortex and left dorsolateral prefrontal cortex (DLPFC), bilateral posterior cingulate cortices, and bilateral inferior parietal lobules. Moreover, greater resting connectivity after IP than RP on Day 1, between the left premotor cortex and the hippocampus, amygdala, putamen, and thalamus on the right, and the cerebellum, was associated with better learning following IP. Mediation analysis further showed that the association between enhanced resting premotor-hippocampal connectivity on Day 1 and better retention performance following IP was mediated by greater task-related functional activation during IP on Day 2. Our findings suggest that the benefit of CI to motor learning is likely through enhanced resting premotor connectivity during the early phase of consolidation.