Linkage and association analysis of ADHD endophenotypes in extended and multigenerational pedigrees from a genetic isolate.

Attention-deficit/hyperactivity disorder (ADHD) is a heritable, chronic, neurodevelopmental disorder with serious long-term repercussions. Despite being one of the most common cognitive disorders, the clinical diagnosis of ADHD is based on subjective assessments of perceived behaviors. Endophenotypes (neurobiological markers that cosegregate and are associated with an illness) are thought to provide a more powerful and objective framework for revealing the underlying neurobiology than syndromic psychiatric classification. Here, we present the results of applying genetic linkage and association analyses to neuropsychological endophenotypes using microsatellite and single nucleotide polymorphisms. We found several new genetic regions linked and/or associated with these endophenotypes, and others previously associated to ADHD, for example, loci harbored in the LPHN3, FGF1, POLR2A, CHRNA4 and ANKFY1 genes. These findings, when compared with those linked and/or associated to ADHD, suggest that these endophenotypes lie on shared pathways. The genetic information provided by this study offers a novel and complementary method of assessing the genetic causes underpinning the susceptibility to behavioral conditions and may offer new insights on the neurobiology of the disorder.

[High resolution 3T magnetic resonance neurography of the peroneal nerve]. / Neurografía de alta resolución del nervio peroneo en resonancia magnética 3T.

Peroneal neuropathy is the most common mononeuropathy of the lower limbs. The causes of peroneal neuropathy include trauma, tumors of the nerve and nerve sheath, entrapment, and others like perineurioma, fibromatosis, lymphoma, and intraneural and externeural ganglia. The diagnosis is based on clinical manifestations and electrophysiological studies. Nowadays, however, magnetic resonance (MR) neurography is a complementary diagnostic technique that can help determine the location and cause of peroneal neuropathy. In this article, we describe the MR anatomy of the peroneal nerve, its relations, and the muscles it innervates. We also discuss the clinical and electrophysiological manifestations of peroneal neuropathy, describe the technical parameters used at our institution, and illustrate the MR appearance of various diseases that involve the peroneal nerve.

A cooperative interaction between LPHN3 and 11q doubles the risk for ADHD.

In previous studies of a genetic isolate, we identified significant linkage of attention deficit hyperactivity disorder (ADHD) to 4q, 5q, 8q, 11q and 17p. The existence of unique large size families linked to multiple regions, and the fact that these families came from an isolated population, we hypothesized that two-locus interaction contributions to ADHD were plausible. Several analytical models converged to show significant interaction between 4q and 11q (P<1 × 10(-8)) and 11q and 17p (P<1 × 10(-6)). As we have identified that common variants of the LPHN3 gene were responsible for the 4q linkage signal, we focused on 4q-11q interaction to determine that single-nucleotide polymorphisms (SNPs) harbored in the LPHN3 gene interact with SNPs spanning the 11q region that contains DRD2 and NCAM1 genes, to double the risk of developing ADHD. This interaction not only explains genetic effects much better than taking each of these loci effects by separated but also differences in brain metabolism as depicted by proton magnetic resonance spectroscopy data and pharmacogenetic response to stimulant medication. These findings not only add information about how high order genetic interactions might be implicated in conferring susceptibility to develop ADHD but also show that future studies of the effects of genetic interactions on ADHD clinical information will help to shape predictive models of individual outcome.

A common variant of the latrophilin 3 gene, LPHN3, confers susceptibility to ADHD and predicts effectiveness of stimulant medication.

Attention-Deficit/Hyperactivity Disorder (ADHD) has a very high heritability (0.8), suggesting that about 80% of phenotypic variance is due to genetic factors. We used the integration of statistical and functional approaches to discover a novel gene that contributes to ADHD. For our statistical approach, we started with a linkage study based on large multigenerational families in a population isolate, followed by fine mapping of targeted regions using a family-based design. Family- and population-based association studies in five samples from disparate regions of the world were used for replication. Brain imaging studies were performed to evaluate gene function. The linkage study discovered a genome region harbored in the Latrophilin 3 gene (LPHN3). In the world-wide samples (total n=6360, with 2627 ADHD cases and 2531 controls) statistical association of LPHN3 and ADHD was confirmed. Functional studies revealed that LPHN3 variants are expressed in key brain regions related to attention and activity, affect metabolism in neural circuits implicated in ADHD, and are associated with response to stimulant medication. Linkage and replicated association of ADHD with a novel non-candidate gene (LPHN3) provide new insights into the genetics, neurobiology, and treatment of ADHD.

ADHD Endophenotypes in Caribbean Families.

Objective: The aim of this study is to contrast the genetics of neuropsychological tasks in individuals from nuclear families clustering ADHD in a Caribbean community. Method: We recruited and clinically characterized 408 individuals using an extensive battery of neuropsychological tasks. The genetic variance underpinning these tasks was estimated by heritability. A predictive framework for ADHD diagnosis was derived using these tasks. Results: We found that individuals with ADHD differed from controls in tasks of mental control, visuospatial ability, visuoverbal memory, phonological and verbal fluency, verbal and semantic fluency, cognitive flexibility, and cognitive ability. Among them, tasks of mental control, visuoverbal memory, phonological fluency, semantic verbal fluency, and intelligence had a significant heritability. A predictive model of ADHD diagnosis using these endophenotypes yields remarkable classification rate, sensitivity, specificity, and precision values (above 80%). Conclusion: We have dissected new cognitive endophenotypes in ADHD that can be suitable to assess the neurobiological and genetic basis of ADHD.

A comprehensive analysis of factors related to carmustine/bevacizumab response in recurrent glioblastoma.

PURPOSE: Patients with recurrent glioblastoma (rGBM) have a poor prognosis, with survival ranging from 25 to 40 weeks. Antiangiogenic agents are widely used, showing a variable response. In this study, we explored the efficacy of carmustine plus bevacizumab (BCNU/Bev) for treating rGBM. METHODS/PATIENTS: In this study, we assessed 59 adult patients with histologically confirmed rGBM who were treated with BCNU/Bev as second-line regimen. The response rate (RR), progression-free survival (PFS) and overall survival (OS) were evaluated according to their molecular expression profile, including CD133 mRNA expression, MGMT methylation (pMGMT), PDGFR amplification, YKL40 mRNA expression, IDH1/2 condition, p53 and EGFRvIII mutation status. RESULTS: Median follow-up was 18.6 months, overall RR to the combination was 56.3%, and median PFS was 9.0 months (95% CI 8.0-9.9). OS from time of diagnosis was 21.0 months (95% CI 13.2-28.7) and from starting BCNU/Bev it was 10.7 months (95% CI 9.5-11.8). IDH1/2 mutations were found in 30.5% of the patients, pMGMT in 55.9% and high CD133 mRNA expression in 57.6%. Factors which positively affected PFS included performance status (p = 0.015), IDH+ (p = 0.05), CD133 mRNA expression (p = 0.009) and pMGMT+ (p = 0.007). OS was positively affected by pMGMT+ (p = 0.05). Meanwhile, YKL40 negatively affected PFS (p = 0.01) and OS (p = 0.0001). Grade ≥ 3 toxicities included hypertension (22%) and fatigue (12%). CONCLUSIONS: BCNU/Bev is a safe and tolerable treatment for rGBM. Patients with MGMT+/IDH+ derive the greatest benefit from the treatment combination in the second-line setting. Nonetheless, high YKL40 expression discourages the use of antiangiogenic therapy.

Phenotypic and molecular characterization of Klebsiella spp. isolates causing community-acquired infections.

Klebsiella spp. isolates from community-acquired infections were characterized. A total of 39 Klebsiella spp. isolates were obtained from outpatients at four rural hospitals in Mexico (2013-2014). The biochemical tests identified all as being K. pneumoniae. The molecular multiplex-PCR test identified 36 (92.4%) K. pneumoniae isolates and one (2.5%) K. variicola isolate, and phylogenetic analysis of the rpoB gene identified two isolates (5.1%) belonging to K. quasipneumoniae subsp. quasipneumoniae and K. quasivariicola. The last one was confirmed by phylogenetic analysis of six-loci concatenated genes. Mostly the isolates were multidrug resistant; however, a minority were extended-spectrum ß-lactamase producing (10.2%). The extended-spectrum ß-lactamase CTX-M-15 gene was identified in these isolates. Analysis of biofilm production and the hypermucoviscosity phenotype showed a total of 35 (92.3%) and seven (17.9%) of the isolates were positive for these phenotypes respectively. The K2 (4/39, 10.2%), K5 (2/39, 5.1%) and K54 (1/39, 2.5%) serotypes were identified in seven (17.9%) of the isolates, and only 28.5% (2/7) hypermucoviscous isolates were positive for the K2 and K5 serotypes. In general, the sequence type (ST) analysis and phylogenetic analysis of seven multilocus sequence typing loci were heterogeneous; however, ST29 was the most prevalent ST in the analysed isolates, accounting for 19% (4/21) of the total isolates. Two of the four ST29 isolates had the hypermucoviscosity phenotype. The virulence factors for fimbriae were the most prevalent, followed by siderophores. Community-acquired infections are caused by various species from Klebsiella genus, with different profiles of antibiotic resistance and heterogeneous virulence factors.

[Validity and reliability of the CERAD-Col neuropsychological battery]. / Validez y fiabilidad de la batería neuropsicológica CERAD-Col.

INTRODUCTION: Alzheimer's disease (AD) is an important public health problem due to its disabling character and high individual, familial and social costs. The CERAD neuropsychological battery has been widely used for evaluation and diagnosis of the cognitive deficit associated with AD. This instrument has been adapted to the Colombian culture (CERAD-Col) for the Neurosciences Group. SUBJECTS AND METHODS: A study was carried out to establish the validity and reliability of the CERAD-Col in Colombian, Spanish-speaking individuals aged 50 years or more. It included 151 controls and 151 AD patients. Controls were selected from a convenience sample of 848 adults aged 50 years or more. The construct validity was determined in three ways: 1) factorial analysis; 2) correlation with the functional scales FAST and GDS (convergent-type validity) and, 3) comparison between the two groups. Internal consistency was determined by means of Cronbach's alpha coefficient. RESULTS: Three factors -memory, language and praxis- explained 88% of the total variance. Moderate but statistically significant correlations were found between neuropsychological tests and functional scales. Internal consistency and test-retest reproducibility were high. The AD group exhibited significantly lower scores (p < 0.05) than the control one. CONCLUSION: CERAD-Col is valid and reliable for the diagnosis of AD in Colombian Spanish-speaking population aged 50 years or more.

[Specific impaired language development: a selective or generalised cognition problem]. / Trastorno específico del desarrollo del lenguaje: problema selectivo o generalizado de la cognición.

INTRODUCTION: Specific developmental language disorder (SDLD) is a diagnostic entity in which language is expected to be the only cognitive function that is affected. Nevertheless, difficulties in other cognitive functions may also appear, either because the language disorder is an expression of an underlying condition or because the retarded language development gives rise to cognitive deficits in general. AIM: To determine whether there are any differences in the cognitive performance of children with SDLD and that of children who have developed normally. SUBJECTS AND METHODS: The study involved a sample of 51 children with SDLD, aged between 6 and 16 years, and 49 children in a control group, who were paired by chronological age, sex and socioeconomic level. Verbal cognitive capacity, attention, memory, visual-constructional and executive functioning were all evaluated. RESULTS: Statistically and clinically significant differences were found in the verbal-type skills, such as language comprehension and verbal cognitive capacity, which showed effect sizes of -1.31 and -1.33, respectively. In the other functions that were assessed, the performance of the SDLD group was slightly lower than that of the control group, but with no clinically significant differences. CONCLUSION: These findings show that the group of children with SDLD was well selected, since the only differences between the two groups involve linguistic aspects; moreover, this evidence supports the idea that language and other cognitive functions are relatively independent and that a language disorder would only generate an unspecific general effect in the other cognitive functions.

A Novel Method for the Treatment of Bilateral Hypogastric Aneurysms Using Hybrid Polytetrafluoroethylene Graft.

Open aortic aneurysm repair in the setting of bilateral hypogastric aneurysms is technically challenging. We present a novel technique for open surgical repair for bilateral hypogastric aneurysms using the Gore hybrid vascular graft (GVHG; W. L. Gore and Associates Inc, Flagstaff, Arizona). The GVHG is an expanded polytetrafluoroethylene graft with a nitinol stent at 1 end designed for hemodialysis access. The GVHG has been also been used for aortic debranching and treatment of occlusive disease. We describe the first report using GVHG to repair hypogastric aneurysms.

[A description of semantic memory performance in a sample of the Antioquian population]. / Descripción del desempeño en memoria semántica en una muestra de la población antioqueña.

INTRODUCTION: Available treatments for Alzheimer disease allow that early diagnosis become an important issue, because treatment only are useful during the earliest stage, especially during the mild cognitive impairment (MCI), when the most of the cognitive function is preserved. AIM: To observe the performance on a shortened version of a Semantic Cue Recall Memory Test (SCRMT) from a group of adult aged over 50 years old, living in Medellin city and with dementia of Alzheimer type (DAT). SUBJECTS AND METHODS: The sample was constituted by 30 patients with DAT, 30 with MCI, and 59 healthy controls, which were matched by socio economic strata and school achievement. The SCRMT was administered to the sample. For the analyses two groups of age (50-69 and over 70 years) were conformed. RESULTS: Comparisons statistically significant differences between the groups (p < 0.05). The scores were not significant affected by age. A combination of low scores with the presence of intrusions on the free, immediate cue, and delay cue recalls suggested the diagnosis of DAT, which allow recommending a complete neuropsychological assessment. Statistically significant differences were preserved when the groups were divided by age. The effect of the gender could not determine because the small size of the male sample. CONCLUSION: The shortened version of the SCMRT would appear be useful for the DAT diagnosis.

Análisis de tratamiento de la otitis media crónica simple con miringoplastía en el Hospital Barros Luco Trudeau

Resumen Introducción: La otitis media crónica simple (OMC) es una patología común en nuestra población y hasta la fecha no queda bien claro cuál técnica y material de injerto da mejores resultados. Objetivo: Determinar si existen diferencias en los resultados anatómicos y funcionales al utilizar fascia de músculo temporal (FMT) versus injerto de cartílago de trago (CT) en los pacientes con OMC en que se les realizó miringoplastía en el Hospital Barros Luco Trudeau. Material y Método: Estudio de cohorte no concurrente de datos obtenidos de la revisión de fichas clínicas. Resultados: De 227 fichas, 154 cumplieron criterios de inclusión. En 102 pacientes (66%) se utilizó FMT y en 52 pacientes (34%) CT. Con FMT 38 presentaron reperforación (37%) y 41 presentaron un éxito funcional (40%). Con CT 18 presentaron reperforación (35%) y 22 presentaron un éxito funcional (42%). 38 pacientes presentaban antecedente de tabaquismo activo y de ellos 53% presentaron reperforación, mientras que de los sin antecedentes de tabaquismo solo un 31%, siendo esta diferencia estadísticamente significativa (p < 0,05). Conclusión: No se obtuvieron diferencias estadísticamente significativas entre los resultados anatómicos y funcionales comparando el uso de injerto FMT y CT para el tratamiento quirúrgico de la OMC simple con miringoplastía.

Abstract Introduction: Simple chronic otitis media (COM) is a common pathology in our population, and it is currently unclear, which grafts technique and material gives the best results. Aim: To determine if there are differences in the anatomical and functional results, when using temporal muscle fascia (FMT) or tragus cartilage graft (CT) in patients with COM who underwent myringoplasty at the Barros Luco Trudeau Hospital. Material and Method: Retrospective analytical cohort study of data obtained from clinical records. Results: Of 227 medical records, 154 met inclusion criteria. FMT was used in 102 patients (66%) and CT in 52 patients (34%). With FMT, 38 had reperforation (37%) and 41 had functional success (40%). With CT 18 had reperforation (35%) and 22 had functional success (42%). 38 patients had a history of active smoking and 53% of them presented reperforation, while of those without a history of smoking only 31%, this difference being statistically significant (p < 0,05). Conclusion: No statistically significant differences were obtained when analyzing the anatomical and functional results comparing the use of FMT and CT graft, for the simple surgical treatment of COM with myringoplasty.

Comparación de sutura mecánica con sutura manual de la faringe en laringectomía total / Comparison of mechanical suture with manual suture of the pharynx in total laryngectomy

Introducción: La sutura mecánica es una opción para el cierre de la faringorrafia en laringectomía total por cáncer de laringe. Objetivo: Comparar el uso de sutura mecánica lineal con sutura manual de la faringe durante la laringectomía total por cáncer de laringe. Material y Método: Se realizó un estudio de tipo experimental prospectivo. Se compararon dos grupos pacientes: Los pacientes con sutura mecánica desde 2018 a marzo de 2020 y los pacientes con sutura manual previa a enero de 2018 en el Servicio de Otorrinolaringología del Hospital Barros Luco. Se analizaron fístula faringo-cutánea posoperatoria (FFC), tiempo operatorio, estadía hospitalaria y costo. Resultados: El estudio incluyó a 14 pacientes, cada grupo con n = 7. El grupo con sutura mecánica presento 0% de FFC y el grupo sutura manual 28%. El grupo con sutura mecánica reinicio alimentación a los 7 días y el grupo con sutura manual en promedio a los 11,5 (7-23) días. (p = 0,0023). El tiempo promedio de cirugía para el grupo experimental es de 288 ± 37,4 minutos y con sutura manual 311 ± 32,4 minutos. (p = 0,0176). El promedio de hospitalización para el grupo experimental fue de 11 ± 2,6 días (9 a 16), y para el grupo control fue de 21 ± 14 días (10 a 49) (p < 0,0001). Conclusión: La sutura mecánica es un procedimiento fácil de usar y seguro. Existiría un beneficio en el uso de sutura mecánica para el cierre faríngeo al compararlo con la sutura manual al disminuir el número de FFC, el tiempo operatorio y los días de hospitalización.

Introduction: Mechanical suture is an option for the closure of the pharyngorrhaphy in total laryngectomy due to laryngeal cancer. Aim: To compare the use of linear mechanical suture with manual pharyngeal suture during total laryngectomy for laryngeal cancer. Material and Method: A prospective experimental study was carried out. Two patient groups were compared: patients with mechanical suture from 2018 to March 2020 and patients with manual suture prior to January 2018 at the otorhinolaryngology service of the Barros Luco Hospital. Postoperative pharyngocutaneous fistula (FFC), operative time, hospital stay and cost were analyzed. Results: The study included 14 patients, each group with n = 7. The group with mechanical suture presented 0% of FFC and the group with manual suture 28%. The group with mechanical suture restarted feeding at 7 days and the group with manual suture on average at 11.5 (7-23) days (p = 0.0023). The average surgery time for the experimental group was 288 ± 37.4 minutes, while for the group with manual suture was 311 ± 32.4 minutes (p = 0.0176). The mean hospitalization for the experimental group was 11 ± 2.6 days (9 to 16), and for the control group it was 21 ± 14 days (10 to 49) (p < 0.0001). Conclusion: The mechanical suture is an easy to use and safe procedure. There would be a benefit in the use of mechanical suture for pharyngeal closure when buying it with manual suture by reducing the number of FFCs, operative time and days of hospitalization.

[Phonological awareness in child with attention deficit disorder without learning disabilities]. / Conciencia fonoloóica en niños con trastorno de la atención sin dificultades en el aprendizaje.

INTRODUCTION: Phonological awareness problems have been reported in children with attention deficit/hyperactivity disorder (ADHD). However, other researches found that phonological awareness problem appear only in children with learning disabilities (LD). OBJECTIVE: To analyze the performance on phonological awareness tasks of children aged 7 to11 years with ADHD combined type (ADHD/+H), and inattentive type (ADHD/-H) compared with one control group. PATIENTS AND METHODS: A non-randomized sample consisting of 96 children of both genders was selected. Children were attending to school in Medellin, Colombia. The sample was classified into three groups of 32 participants: ADHD/+H, ADHD/-H and control. LD was excluded using a standardized questionnaire for teachers (CEPA). Groups were sorted using a T score (3) 60 for cases and T score pound 50 for controls on a standardized questionnaire with DSM-IV-ADHD criteria, and on an ADHD-DSM-IV checklist. The performances of the three groups on phonological awareness tasks, as auditory discrimination, visual recognition, sequential repetition, oral segmentation, syllable inversion, similar words reading and writing, and pseudo-words reading and writing, were compared. RESULTS: Differences between ADHD and control children on phonological awareness tasks scores were not found. CONCLUSION: Children with ADHD without LD performed similarly to controls on phonological awareness tasks.

[Attention and executive function tests components in attention deficit/hyperactivity children]. / Componentes de las pruebas de atención y función ejecutiva en niños con trastorno por déficit de atención/hiperactividad.

INTRODUCTION: It has been suggested that children with attention deficit/hyperactivity disorder (ADHD) have problems in attention and executive functions. A factor analysis showed that ADHD children had a different factor structure of the executive functions when they were compared with controls. AIM. To determine the factor structure of attention and executive functions in a group of ADHD children compared with a group of controls. SUBJECTS AND METHODS: 249 ADHD children and 372 controls of both genders, aged 6 to 11 years old, and from the different socio economic strata of Medellín city, were selected. Attention --Mental Control and Auditory Continuous Performance Test (ACPT)-- and executive functions --Phonologic and Semantic Verbal Fluency (FAS)--, and a shortened version of the Wisconsin Card Sorting Test (WCST) were assessed in both groups. Factor analyses were developed with principal components procedure were developed for each group and the total sample, using principal component procedure with orthogonal rotation. RESULTS: Stable factor structures were found for each group and for the total sample. The general factor structure was constituted by three independent factors: 1- Categorization, 2- Verbal fluency and verbal sustained attention, and 3- Cognitive flexibility. This factor structure explained 74.9% of the variance. CONCLUSION: The factor structures suggested that the components of attention and executive functions are similar for ADHD and control groups. The differences between groups would be quantitative.

Deciphering interference control in adults with ADHD by using distribution analyses and electromyographic activity.

A deficit in "interference control" is commonly found in adults with Attention Deficit Hyperactivity Disorder (ADHD). This has mainly been interpreted as difficulties in inhibiting inappropriate responses. However, interference control involves processes other than simply the ability to inhibit. Consequently, we used sophisticated analysis to decipher the additional processes of interference control in these patients. We compared interference control between 16 adults with ADHD and 15 control adults performing a Simon task. In most studies, performance is generally reported in terms of mean error rates and reaction times (RTs). However, here we used distribution analyses of behavioral data, complemented by analyses of electromyographic (EMG) activity. This allowed us to better quantify the control of interference, specifically the part that remains hidden when pure correct trials are not distinguished from partial errors. Partial errors correspond to sub-threshold EMG bursts induced by incorrect responses that immediately precede a correct response. Moreover, besides "online" control, we also investigated cognitive control effects manifesting across consecutive trials. The main findings were that adults with ADHD were slower and showed a larger interference effect in comparison to controls. However, the data revealed that the larger interference effect was due neither to higher impulse expression, nor to a deficit in inhibition but that these patients presented a larger interference effect than the controls after congruent trials. We propose and discuss the hypothesis that the interference control deficit found in adults with ADHD is secondary to impairments in sustained attention.

A novel Cys212Tyr founder mutation in parkin and allelic heterogeneity of juvenile Parkinsonism in a population from North West Colombia.

We report the molecular characterization of three multiplex families and a sporadic case of juvenile Parkinsonism identified in the province of Antioquia (Colombia). Linkage and haplotype analysis using markers in 6q25.2-27 indicated that Parkinsonism in the pedigrees is linked to the parkin gene (maximum LOD-score of 3.85) but that they carry two different mutant haplotypes. Sequence analysis revealed a novel G to A transition in exon 6 at position 736 (G736A) of parkin. This change results in a non-conservative cysteine for tyrosine substitution. All affected individuals from two families were homozygous for this mutation, which was not detected in 100 normal controls. Patients from the family carrying the second haplotype and the sporadic case were homozygous for a GT insertion in exon 3. This mutation has been previously identified in French families with juvenile Parkinsonism. The concomitant presence of founder effects and allelic heterogeneity in Antioquia might relate to the founding admixture at the origin of this population.

Correlation between intelligence test scores and executive function measures.

In this study, some executive function measures (Wisconsin Card Sorting Test [WCST], verbal fluency, and Trial Making Test [TMT], Form A and Form B) were correlated with Wechsler Intelligence Scale for Children-Revised (WISC-R) scores. Fifty 13- to 16-year-old normal children were selected. It was found that verbal fluency tests correlated about 0.30 with Verbal Intelligence Quotient (IQ) and Full Scale IQ. In the WCST only Perseverative Errors negatively correlated with Verbal IQ and Full Scale IQ. Two correlations were found to be significant with regard to the TMT: TMT Form B Errors negatively correlated with WISC-R Vocabulary subtest; and TMT Form A Time negatively correlated with Performance IQ. These results support the assumption that traditional intelligence tests are not appropriately evaluating executive functions.

Prevalence of attention-deficit/hyperactivity disorder symptoms in 4- to 17-year-old children in the general population.

The purposes of this study were (a) to estimate the prevalence of Attention-Deficit/Hyperactivity Disorder (AD/HD) symptoms in the general preschool and school population; and (b) to analyze the influence of gender, age, and socioeconomic status (SES) variables on AD/HD symptoms. Out of the 80,000 preschool and schoolchildren living in Manizales, Colombia, a random sample of 540 children was selected. Two gender, three age (4- to 5-year olds, 6- to 11-year olds, and 12- to 17-year olds), and three SES (low, middle, and high) groups were used. The 18 DSM-IV symptoms corresponding to AD/HD Criterion A were assessed on a scale of 0 (never) to 3 (almost always). All three demographic variables established statistically significant differences: AD/HD symptoms were more frequent in 6- to 11-year-old, low-SES, male participants. DSM-IV Criterion A for AD/HD was fulfilled by 19.8% of the boys and 12.3% of the girls. However, this difference was marginally significant only in the AD/HD Subtype I: Combined. It was concluded that demographic variables are significant correlates of the AD/HD diagnosis. The prevalence found in this study was higher than usually reported, even though only the symptomatic DSM-IV AD/HD criterion was analyzed. We failed to confirm the assumed AD/HD gender ratio.