Sensory Gating Capacity and Attentional Function in Adults With ADHD: A Preliminary Neurophysiological and Neuropsychological Study.

Objective: The inability to filter sensory input correctly may impair higher cognitive function in ADHD. However, this relationship remains largely elusive. The objectives of the present study is to investigate the relationship between sensory input processing and cognitive function in adult patients with ADHD. Method: This study investigated the relationship between deficit in sensory gating capacity (P50 amplitude changes in a double-click conditioning-testing paradigm and perceptual abnormalities related to sensory gating deficit with the Sensory Gating Inventory [SGI]) and attentional and executive function (P300 amplitude in an oddball paradigm and attentional and executive performances with a neuropsychological test) in 24 adult patients with ADHD. Results: The lower the sensory gating capacity of the brain and the higher the distractibility related to sensory gating inability that the patients reported, the lower the P300 amplitude. Conclusion: The capacity of the brain to gate the response to irrelevant incoming sensory input may be a fundamental protective mechanism that prevents the flooding of higher brain structures with irrelevant information in adult patients with ADHD.

[Other therapeutic strategies]. / Dépression résistante : les autres stratégies thérapeutiques.

Non-selective and irreversible MAOI have become as third or fourth-line strategy for the management of treatment-resistant depression. Non-selective and irreversible MAOI requires careful monitoring of drug interactions and dietary restrictions. Nutritional supplements such as omega-3 have been found to produce beneficial effects in the management of treatment-resistant depression when administered in combination with the ongoing antidepressant treatment. The glutamate antagonist ketamine has been found to produce beneficial effects in the management of treatment-resistant depression while administered alone. Dopamine and/or norepinephrine agonists, such as methylphenidate, modafinil or pramipexole, have been found to produce beneficial effects in the management of treatment-resistant depression when administered in combination with the ongoing antidepressant treatment.

Sensory gating in adult with attention-deficit/hyperactivity disorder: Event-evoked potential and perceptual experience reports comparisons with schizophrenia.

BACKGROUND: In daily life, adults with attention-deficit/hyperactivity disorder (ADHD) report abnormal perceptual experiences that can be related to sensory gating deficit. This study investigated and compared P50 suppression (a neurophysiological measure of sensory gating) and perceptual abnormalities related to sensory gating deficit in ADHD and schizophrenias patients. METHODS: Three groups were compared: 24 adults with ADHD, 24 patients with schizophrenia and 24 healthy subjects. The Sensory Gating Inventory (SGI), a validated self-report questionnaire, was used to measure perceptual abnormalities related to sensory gating deficit. P50 suppression was measured by P50 amplitude changes in a dual-click conditioning-testing auditory event-related potential procedure. RESULTS: Adults with ADHD had significantly higher scores on the SGI and significantly lower P50 suppression than healthy subjects. These deficits were similar to those found in patients with schizophrenia. A correlation was found between both the SGI and P50 suppression data in adults with ADHD and patients with schizophrenia. DISCUSSION: The findings confirm previous results found in patients with schizophrenia. Moreover, adults with ADHD, similar to patients with schizophrenia, had abnormal P50 suppression and reported being flooded with sensory stimuli. Abnormal neurophysiologic responses to repetitive stimuli gave rise to clinically abnormal perceptions.