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BACKGROUND: Previous studies that have assessed social cognition in Attention-Deficit/Hyperactivity Disorder (ADHD) have produced inconsistent findings. To summarize these data and shed light upon moderators that may explain observed inconsistencies, we conducted a systematic review and meta-analysis exploring social cognition (Theory of Mind (ToM), Empathy, Facial and Non-Facial Emotion Recognition) and Everyday Social Skills in children and adolescents with ADHD. METHODS: The current meta-analysis involved 142 studies including 652 effect sizes. These studies compared children and adolescents with ADHD (n = 8,300) and with typical development (n = 7,983). RESULTS: Participants with ADHD exhibited moderate to very large deficits in ToM (SMD = 0.84, 95% CI = 0.68-0.99), Facial Emotion Recognition (SMD = 0.63, 95% CI = 0.46-0.81), and Everyday Social Skills (SMD = 1.23, 95% CI = 1.08-1.37). The magnitude of these impairments was similar when considering effect sizes adjusted for some covariates and the methodological quality of the studies. Few studies have investigated Empathy and Non-Facial Emotion Recognition, which precludes definitive conclusions. CONCLUSIONS: Children and adolescents with ADHD experience robust impairments in ToM, Facial Emotion Recognition and Everyday Social Skills. Future studies should explore whether these deficits are a consequence of difficulties in other areas of cognition (e.g., executive functioning). We have made all our raw data open access to facilitate the use of the present work by the community (e.g., clinicians looking for tools, assessing social impairments, or researchers designing new studies).
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Introduction: Fetal Alcohol Spectrum Disorders (FASD) are characterized by a variety of multiple cognitive and behavioral impairments, with intellectual, attentional, and executive impairments being the most commonly reported. In populations with multiple neurodevelopmental disorders, the Full Scale Intelligence Quotient (FSIQ) may not be a proper measure of intellectual abilities, rarely interpreted in FASD clinical practice because the heterogeneity of the cognitive profile is deemed too strong. We propose a quantitative characterization of this heterogeneity, of the strengths and weaknesses profile, and a differential analysis between global cognitive (FSIQ) and elementary reasoning abilities in a large retrospective monocentric FASD sample. Methods: Using clinical and cognitive data (Wechsler Intelligence Scale for Children) from 107 children with FASD, we characterized subject heterogeneity (variance and scatter of scaled/composite scores), searched for strengths and weaknesses, and specified intellectual functioning in terms of FSIQ and elementary reasoning (General Abilities Index, Highest Reasoning Scaled Score), in comparison with standardization norms and a Monte-Carlo-simulated sample from normalization data. Results: Performance of children with FASD was lower on all subtests, with a significant weakness in working memory and processing speed. We found no increase in the variance and scatter of the scores, but a discordance between the assessment of global cognitive functioning (28% borderline, 23% deficient) and that of global and elementary reasoning abilities (23-9% borderline, 15-14% deficient). Conclusion: Our results question the notion of WISC profile heterogeneity in FASD and point to working memory and processing speed over-impairment, with global repercussions but most often preserved elementary reasoning abilities.
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Functional hemispherectomy results in good outcomes in cases of refractory epilepsy and constitutes a unique situation in which to study cerebral plasticity and the reorganization of lateralized functions of the brain, especially in cases of infancy or childhood surgery. Previous studies have highlighted the remarkable ability of the brain to recover language after left hemispherectomy. This leads to a reorganization of language networks toward right hemisphere, causing limitation in the development of visuo-spatial abilities, known as a crowding effect in the right hemisphere. Deficits in nonverbal functions have also been described as a more direct consequence of right hemipherectomy, but the results from case studies have sometimes been contradictory. We conducted a group study which may effectively compare patients with left and right hemispherectomy and address the effects of the age of seizure onset and surgery. We analyzed the general visuo-spatial and visuo-perceptive abilities, including face and emotional facial expression processing, in a group of 40 patients aged 7-16 years with left (n = 24) or right (n = 16) functional hemispherectomy. Although the groups did not differ, on average, in general visuo-spatial and visuo-perceptive skills, patients with right hemispherectomy were more impaired in the processing of faces and emotional facial expressions compared with patients with left hemispherectomy. This may reflect a specific deficit in the perceptual processing of faces after right hemispherectomy. Results are discussed in terms of limited plasticity of the left hemisphere for facial and configural processing.
Subject(s)
Drug Resistant Epilepsy , Hemispherectomy , Child , Functional Laterality , Humans , Language , SeizuresABSTRACT
INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with symptoms, especially the hyperactive ones, that tend to decrease in severity with age. Interestingly, children born just before the school-entry cut-off date (ie, the youngest pupils of a classroom) are at higher risk of being diagnosed with ADHD compared with children born just after the cut-off date. Noteworthy, this month-of-birth effect tends to disappear with increasing absolute age. Therefore, it is possible that young children erroneously diagnosed with ADHD due to their month of birth present a lower chance to have their diagnosis confirmed at a later age, artificially reinforcing the low persistence of ADHD across the lifespan. This protocol outlines an individual patient data (IPD) meta-analysis of prospective observational studies to explore the role of the month of birth in the low persistence of ADHD across the lifespan. METHODS AND ANALYSIS: Five databases will be systematically searched in order to find prospective observational studies where the presence of ADHD is assessed both at baseline and at a follow-up of at least 4 years. We will use a two-stage IPD meta-analytic approach to estimate the role of the month of birth in the persistence of ADHD. Various sensitivity analyses will be performed to assess the robustness of the results. ETHICS AND DISSEMINATION: No additional data will be collected and no de-identified raw data will be used. Ethics approval is thus not required for the present study. Results of this IPD meta-analysis will be submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020212650.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Attention Deficit Disorder with Hyperactivity/epidemiology , Child , Child, Preschool , Humans , Meta-Analysis as Topic , Observational Studies as Topic , Prospective Studies , SchoolsABSTRACT
Past empirical studies have suggested that older adults preferentially use gaze-based mood regulation to lessen their negative experiences while watching an emotional scene. This preference for a low cognitively demanding regulatory strategy leaves open the question of whether the effortful processing of a more cognitively demanding reappraisal task is really spared from the general age-related decline. Because it does not allow perceptual attention to be redirected away from the emotional source, music provides an ideal way to address this question. The goal of our study was to examine the affective, behavioral, physiological, and cognitive outcomes of positive and detached reappraisal in response to negative musical emotion in younger and older adults. Participants first simply listened to a series of threatening musical excerpts and were then instructed to either positively reappraise or to detach themselves from the emotion elicited by music. Findings showed that, when instructed to simply listen to threatening music, older adults reported a more positive feeling associated with a smaller SCL in comparison with their younger counterparts. When implementing positive and detached reappraisal, participants showed more positive and more aroused emotional experiences, whatever the age group. We also found that the instruction to intentionally reappraise negative emotions results in a lesser cognitive cost for older adults in comparison with younger adults. Taken together, these data suggest that, compared to younger adults, older adults engage in spontaneous downregulation of negative affect and successfully implement downregulation instructions. This extends previous findings and brings compelling evidence that, even when auditory attention cannot be redirected away from the emotional source, older adults are still more effective at regulating emotions. Taking into account the age-associated decline in executive functioning, our results suggest that the working memory task could have distracted older adults from the reminiscences of the threat-evoking music, thus resulting in an emotional downregulation. Hence, even if they were instructed to implement reappraisal strategies, older adults might prefer distraction over engagement in reappraisal. This is congruent with the idea that, although getting older, people are more likely to be distracted from a negative source of emotion to maintain their well-being.
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Many studies have examined the effect of aging on the ability to regulate negative emotions but less is known about the way the elderly people control their positive affects. Thirty-eight younger and 38 older adults were compared on their affective, expressive, physiological, and behavioral spontaneous responses to and in expressive regulation of mirth elicited by humorous cartoons. Compared to younger adults, older adults were equally amused and aroused but showed lower expressivity in their spontaneous reaction. They were similarly successful in implementing expressive regulation but they had lower physiological activation under amplification condition and more gaze avoidance from the key areas of the cartoons under suppression condition. This indicates that in older, amplification skills are disjointed from the physiological responses and suppression skills seem supplanted by a less costly strategy of attention redeployment. This also suggests that older adults' behavior is not driven by a greater preference for positive information.
Subject(s)
Cartoons as Topic/psychology , Emotional Regulation , Expressed Emotion , Wit and Humor as Topic , Adult , Age Factors , Aged , Arousal , Humans , Middle Aged , Neuropsychological Tests , Personality Inventory , Psychological Tests , Young AdultABSTRACT
The hippocampus and the adjacent perirhinal, entorhinal, temporopolar, and parahippocampal cortices are interconnected in a hierarchical MTL system crucial for memory processes. A probabilistic description of the anatomical location and spatial variability of MTL cortices in the child and adolescent brain would help to assess structure-function relationships. The rhinal sulcus (RS) and the collateral sulcus (CS) that border MTL cortices and influence their morphology have never been described in these populations. In this study, we identified the aforementioned structures on magnetic resonance images of 38 healthy subjects aged 7-17 years old. Relative to sulcal morphometry in the MTL, we showed RS-CS conformation is an additional factor of variability in the MTL that is not explained by other variables such as age, sex and brain volume; with an innovative method using permutation testing of the extrema of structures of interest, we showed that RS-SC conformation was not associated with differences of location of MTL sulci. Relative to probabilistic maps, we offered for the first time a systematic mapping of MTL structures in children and adolescent, mapping all the structures of the MTL system while taking sulcal morphology into account. Our results, with the probabilistic maps described here being freely available for download, will help to understand the anatomy of this region and help functional and clinical studies to accurately test structure-function hypotheses in the MTL during development. Free access to MTL pediatric atlas: http://neurovault.org/collections/2381/.
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The links between deficits in executive functions (EFs) (e.g., mental flexibility, inhibition capacities, etc.) and some psychological disorders (e.g., anxiety and depressive disorders) have been investigated in the past decades or so. Observations evidenced that some deficits in working memory, planning, and mental flexibility were highly correlated with anxiety and depressive disorders. The majority of studies focused on adults' population, whereas it seems important to adopt a developmental perspective to fully understand the dynamic relation of these EF/psychological disorders. We suggest to focus on the following two axes in future research: (i) relations between EF and anxiety traits through development and (ii) the possible role of external factors such as parent-child relationships on the development of EF.
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PURPOSE: Hemispherotomy (H) is the standard treatment used to cure hemispheric epileptic syndromes in childhood. The postoperative linguistic profile involves hemispheric specialization processes and developmental cognitive plasticity. This research concerns pragmatic aspects of language as a tool for communication which involves both linguistic and extralinguistic communication in context. Our aim was to analyze whether any correlation exists with age at surgery and side of surgery on pragmatic skills following H. METHOD: Forty children who underwent H (23 females, 16 right H) were evaluated at a mean age of 12.8 years (±2.6) with two receptive tasks (oral comprehension and syntactic judgment), the Children's Communication Checklist (CCC) rating scale, and the Behavioral Rating Inventory of Executive Function (BRIEF) questionnaire in order to evaluate the role of executive functions on pragmatic skills. Children operated on before the age of 18 months were considered the "early" group (5 right H and 9 left H), while those operated on later were called the "late" group (11 right H and 15 left H). KEY FINDINGS: The whole group had significant deficits in all three measures. We demonstrated a statistically significant crossed interaction between the side of H and the age at H with pragmatic language impairments (F(1,36)=17.48; p=.0002) and disorders in executive function (F(1,36)=5.80; p=.021) in left early H and in right late H patients. These findings are consistent with the previous studies of pragmatic language impairments concerning adolescents and adults with right hemisphere damage and emphasize the contribution of structural language in the early stage of verbal communication. SIGNIFICANCE: These results emphasize for the first time that hemispherotomized children have pragmatic language impairments that are independent of receptive language. Our findings are congruent with the recent theory on pragmatic language development in childhood with evidence of a participation of the left hemisphere at the early age followed by right hemispheric specialization and involvement of executive functions, independently of receptive language.
Subject(s)
Dominance, Cerebral/physiology , Epilepsy/surgery , Language Disorders/etiology , Language , Neurosurgical Procedures/adverse effects , Speech/physiology , Adolescent , Child , Communication , Comprehension/physiology , Female , Humans , Language Tests , MaleABSTRACT
AIM: Theory of mind impairments are part of the cognitive morbidities associated with transposition of the great arteries (TGA). We sought to assess core components of social cognition in school-aged children with TGA. METHOD: Thirty-eight children with neonatal corrected TGA (27 males, 11 females; mean age 7y 3mo, SD 1y 2mo) and a comparison group (n=31; 24 males, 7 females; mean age 7y 4mo, SD 1y 1mo) participated in this study. All children completed measures of facial expression recognition, emotion comprehension, and second-order cognitive and affective false-belief tasks. The association of medical pre-, intra-, and postoperative variables with cognitive outcomes was explored. RESULTS: After controlling for potential covariates, children with TGA performed significantly less accurately in the mental category of the emotion comprehension battery (p=0.002) and on second-order affective false-belief tasks (p<0.05). Preoperative variables including an associated ventricular septal defect (p=0.02), a younger age at open-heart surgery (p=0.03), and a prenatal diagnosis of TGA (p=0.02) were significantly associated with better outcomes. INTERPRETATION: School-aged children with TGA display significant impairment on complex affective mental state understanding even though facial expression recognition was generally preserved. Preoperative factors may be important determinants for long-term outcomes after cyanotic congenital heart disease.
Subject(s)
Cognition Disorders/psychology , Emotional Intelligence , Facial Expression , Postoperative Complications/psychology , Recognition, Psychology , Theory of Mind , Transposition of Great Vessels/surgery , Child , Child, Preschool , Cognition Disorders/diagnosis , Comorbidity , Comprehension , Female , Follow-Up Studies , Heart Septal Defects, Ventricular/psychology , Heart Septal Defects, Ventricular/surgery , Humans , Infant , Infant, Newborn , Male , Neuropsychological Tests/statistics & numerical data , Postoperative Complications/diagnosis , Prognosis , Psychometrics , Transposition of Great Vessels/psychologyABSTRACT
OBJECTIVES: To characterize the prevalence of use of early remedial services and its associated demographic, medical, and cognitive factors in children aged 4-6 years with corrected transposition of the great arteries (TGA). STUDY DESIGN: This was a prospective study of neurocognitive outcomes after TGA. Children underwent formal neuropsychological testing including general intelligence and a comprehensive battery of executive functions (EF) including motor and interference control, short-term memory, and working memory as well as cognitive flexibility. Parental reports on the children's behavior and EF were also evaluated. Demographic factors and preoperative, intraoperative, and postoperative factors as well as cognitive factors were examined according to the current use of remediation. RESULTS: Forty-five patients (67% male) and their parents participated in this study. Twenty-four (53%) patients were receiving remedial services. Male sex, a postnatal diagnosis of TGA, and a longer postoperative intensive care unit stay were significantly associated with use of remediation. Children receiving remediation had lower EF scores, had more severe EF deficits as observed by formal testing, and were rated as having more behavioral daily life difficulties. However, in the group without remediation, 13 children (43%) also displayed EF deficits rated as moderate to severe. CONCLUSIONS: Demographic and medical factors could help identify children at higher risk for neurocognitive delays. Evaluation of executive functioning from an early age may influence referral for remediation.
Subject(s)
Developmental Disabilities/therapy , Early Intervention, Educational , Transposition of Great Vessels/physiopathology , Transposition of Great Vessels/surgery , Child , Child, Preschool , Developmental Disabilities/diagnosis , Emotions , Female , Humans , Intelligence Tests , Male , Neuropsychological Tests , Parents , Prospective Studies , RiskABSTRACT
Enhanced memory for emotional faces is a significant component of adaptive social interactions, but little is known on its neural developmental correlates. We explored the role of amygdaloid complex (AC) and medial temporal lobe (MTL) in emotional memory recognition across development, by comparing fMRI activations of successful memory encoding of fearful and neutral faces in children (n = 12; 8-12 years) and adolescents (n = 12; 13-17 years). Memory for fearful faces was enhanced compared with neutral ones in adolescents, as opposed to children. In adolescents, activations associated with successful encoding of fearful faces were centered on baso-lateral AC nuclei, hippocampus, enthorhinal and parahippocampal cortices. In children, successful encoding of fearful faces relied on activations of centro-mesial AC nuclei, which was not accompanied by functional activation of MTL memory structures. Successful encoding of neutral faces depended on activations in anterior MTL region (hippocampal head and body) in adolescents, but more posterior ones (hippocampal tail and parahippocampal cortex) in children. In conclusion, two distinct functional specializations emerge from childhood to adolescence and result in the enhancement of memory for these particular stimuli: the specialization of baso-lateral AC nuclei, which is associated with the expertise in processing emotional facial expression, and which is intimately related to the specialization of MTL memory network. How the interplay between specialization of AC nuclei and of MTL memory structures is fundamental for the edification of social interactions remains to be elucidated.
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INTRODUCTION: Recognition memory may be enhanced for emotional stimuli compared to neutral ones. Neuropsychological studies in adults with temporal lobe epilepsy (TLE) have reported disorders in this emotional memory enhancement but few studies have focused on children and adolescents with TLE. However these young patients are at particular risk for memory impairments. METHODS: We included 25 patients aged 8-18 years with temporal lobe resection (TLR) for refractory TLE and compared them with 50 age-matched healthy controls for emotional memory recognition tasks involving faces and words. Recollection and familiarity memory processes were explored using the R/K/G paradigm and identification of emotional facial expressions was evaluated. RESULTS: In the control group, recognition was enhanced for emotional faces and words compared to neutral ones. In patients, no memory enhancement effect was found, except for fearful faces. Memory enhancement for fearful faces relied on familiarity-based judgments in patients whereas it was supported by recollection in controls. In left-TLR patients, memory recognition of emotional material was correlated with identification of emotional facial expressions whereas this was not the case for right-TLR patients. CONCLUSION: Together, these findings indicate that temporal lobe integrity is crucial for children to develop normal interactions between emotions and memory. In the case of early lesions, fearful expressions might possibly increase memory for faces but through familiarity rather than through recollection as in healthy individuals.
Subject(s)
Emotions/physiology , Epilepsy, Temporal Lobe/physiopathology , Face/physiopathology , Memory/physiology , Temporal Lobe/physiopathology , Adolescent , Child , Epilepsy, Temporal Lobe/pathology , Epilepsy, Temporal Lobe/surgery , Facial Expression , Humans , Judgment/physiology , Neuropsychological Tests , Recognition, Psychology , Temporal Lobe/pathology , Temporal Lobe/surgeryABSTRACT
That emotional memory enhancement is compromised in adult patients with temporal lobe epilepsy (TLE), particularly in the case of early cerebral damage, has been suspected. We conducted a study in which we compared 20 children and adolescents aged 11-15 years with early TLE with 40 healthy control subjects. We studied the effect of emotional information on verbal memory performance using story recall and word list learning tasks. Our results highlighted the existence of emotional memory facilitation in healthy subjects, whereas there was no beneficial impact of emotional material on memory in young patients with TLE. Our study suggests that early TLE can impair the development of emotional memory processes.