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1.
PLoS One ; 15(3): e0224343, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32126073

RESUMO

This study investigated the association between attention-deficit/hyperactivity disorder (ADHD) symptomatology in preschool-aged children who were born very preterm (<33 weeks) and cognitive outcomes, clinical risk and socio-demographic characteristics. 119 very preterm children who participated in the Evaluation of Preterm Imaging Study at term-equivalent age were assessed at a mean age of 4.5 years. Parents completed the ADHD Rating Scale IV, a norm-referenced checklist that evaluates ADHD symptomatology according to diagnostic criteria, and the Behavior Rating Inventory of Executive Function-Preschool version. Children completed the Wechsler Preschool and Primary Scales of Intelligence and the Forward Digit Span task. Longitudinal data including perinatal clinical, qualitative MRI classification, socio-demographic variables and neurodevelopmental disabilities were investigated in relation to ADHD symptomatology. All results were corrected for multiple comparisons using false discovery rate. Results showed that although the proportion of very preterm children with clinically significant ADHD did not differ from normative data after excluding those with neurodevelopmental disabilities, 32.7% met criteria for subthreshold ADHD inattentive type and 33.6% for combined type, which was higher than the expected 20% in normative samples. Higher ADHD symptom scores (all) were associated with greater executive dysfunction (inhibitory self-control, flexibility, and emergent metacognition, corrected p<0.001 for all tests). Higher inattentive ADHD symptom scores were associated with lower IQ (ρ = -0.245, p = 0.011) and higher perinatal clinical risk (more days on mechanical ventilation (ρ = 0.196, p = 0.032) and more days on parenteral nutrition (ρ = 0.222, p = 0.015). Higher hyperactive ADHD symptom scores instead were associated with lower socio-economic status (ρ = 0.259, p = 0.004). These results highlight the importance of monitoring and supporting the development of very preterm children throughout the school years, as subthreshold ADHD symptoms represent risk factors for psychosocial problems and for receiving a future clinical diagnosis of ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Desenvolvimento Infantil , Cognição , Lactente Extremamente Prematuro , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez
2.
Medicina (B Aires) ; 80 Suppl 2: 58-62, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32150715

RESUMO

Epilepsy and attention deficit and hyperactivity disorder (ADHD) are frequent conditions in pediatrics. Their association is frequent and complex, often sharing psychiatric comorbidity. Patients who present epilepsy and ADHD, show equal frequency in both genders, with the inattentive type, as predominant presentation. Cognitive deficit increases the risk of associating ADHD in patients with epilepsy. There is not enough evidence for other risk factors, however there is enough information that allows to ant icipate its presence in some types of epilepsy, with neuropsychological models that evidence the underlying network dysfunction. The relationship with frequency and seizure control, electroencephalographic alterations and antiepileptic drugs (AEDs) is also reviewed. Recommendations to reduce adverse effects of AEDs are described. The diagnosis must therefore be based on suspicion, through clinical instruments and assessments of cognitive functioning. Multimodal treatment is also recommended in patients with ADHD with and without epilepsy. Psych stimulants can be used safely. The quality of life of the patients and their families is affected, so it is advisable for them to be supported by a specialized team that could provide education, early assessment and therapy. If they are omitted, the consequences can be negative at school, social environment and emotional development, which could be relevant and become persistent.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Epilepsia/complicações , Epilepsia/fisiopatologia , Anticonvulsivantes/uso terapêutico , Criança , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Comorbidade , Epilepsia/tratamento farmacológico , Humanos , Fatores de Risco
3.
Medicina (B Aires) ; 80 Suppl 2: 63-66, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32150716

RESUMO

Theta-Beta (T / B) ratio of the quantified electroencephalogram (EEGQ) in patients with attention deficit hyperactivity disorder (ADHD) constitutes a characteristic EEG variable of the primary disorder with an overall accuracy of 89%. The objective of this study was to measure the T/B ratio in a sample of patients with ADHD and the effects of the treatment with psychostimulants and non-psychostimulants on the T/B ratio. The sample consisted of 85 children between 6 and 18 years (68 males and 17 females) with the diagnosis of the inattentive and combined subtype of ADHD, according to the criteria of the DSM-V. An EEGQ was performed with measurement of the T/B ratio before and after 6 months of treatment with psychostimulant and non-psychostimulant drugs. Both groups were compared using the Wilcoxon signed range test for related samples. The results showed that 86% of the cases had a T/B ratio above the normal values for the age of them. The reduction in the T/B ratio was statistically significant in the group of patients treated with psychostimulants. The reduction of non-psychostimulants was not significant. In conclusion, we confirmed the high T/B ratio in patients with ADHD. Psychostimulant drugs decrease the elevated T/B ratio in patients with ADHD after 6 months of treatment.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Ritmo beta/fisiologia , Estimulantes do Sistema Nervoso Central/uso terapêutico , Eletroencefalografia/métodos , Ritmo Teta/fisiologia , Adolescente , Fatores Etários , Criança , Feminino , Humanos , Masculino , Valores de Referência , Estatísticas não Paramétricas , Resultado do Tratamento
4.
Medicina (B Aires) ; 80 Suppl 2: 72-75, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32150718

RESUMO

Attention deficit and hyperactivity disorder (ADHD) is a neurobiological disorder frequent in childhood. The main symptoms are attention disorder and/or impulsivity and/or hyperactivity. There are different subtypes of ADHD according to the degree of presence of these three symptoms. There are different therapeutic approaches with high proved effectiveness. Methylphenidate, a stimulant that acts through the dopaminergic and adrenergic pathways, is commonly used for the treatment of ADHD. The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioural screening instrument internationally used for the screening of mental health problems in children and adolescents. It consists in a 25 items questionnaire with 5 different scales: emotional symptoms, conduct problems, hyperactivity / inattention, peer relationship problems and prosocial behaviours. The SDQ score was collected in a sample of ADHD patients with an age between 7 and 12 years. The score obtained before starting treatment with methylphenidate was compared before and after starting treatment, every 3-6 months and up to a period of 2 years. Statistical processing was performed using R, which is a free program for statistical and graphical analysis, that allows temporary analysis. The results indicate that hyperactivity improves throughout the first year of treatment, emotional symptoms and behavioral problems improve during the first 6 months of treatment, pro-social symptoms slowly improve over 2 years. Problems with partners do not improve in the analyzed time.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Inibidores da Captação de Dopamina/uso terapêutico , Metilfenidato/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Progressão da Doença , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Visita a Consultório Médico , Análise de Regressão , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
5.
Lancet ; 395(10222): 450-462, 2020 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-31982036

RESUMO

Attention-deficit hyperactivity disorder (ADHD), like other psychiatric disorders, represents an evolving construct that has been refined and developed over the past several decades in response to research into its clinical nature and structure. The clinical presentation and course of the disorder have been extensively characterised. Efficacious medication-based treatments are available and widely used, often alongside complementary psychosocial approaches. However, their effectiveness has been questioned because they might not address the broader clinical needs of many individuals with ADHD, especially over the longer term. Non-pharmacological approaches to treatment have proven less effective than previously thought, whereas scientific and clinical studies are starting to fundamentally challenge current conceptions of the causes of ADHD in ways that might have the potential to alter clinical approaches in the future. In view of this, we first provide an account of the diagnosis, epidemiology, and treatment of ADHD from the perspective of both the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the eleventh edition of the International Classification of Diseases. Second, we review the progress in our understanding of the causes and pathophysiology of ADHD on the basis of science over the past decade or so. Finally, using these discoveries, we explore some of the key challenges to both the current models and the treatment of ADHD, and the ways in which these findings can promote new perspectives.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estimulantes do Sistema Nervoso Central/efeitos adversos , Humanos , Guias de Prática Clínica como Assunto
6.
Environ Health Prev Med ; 24(1): 74, 2019 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-31812162

RESUMO

BACKGROUND: There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated. METHODS: This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children's Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22-0.51 ng/ml (low-passive smoker), 0.52-11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker). RESULTS: Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys. CONCLUSION: Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Exposição Materna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/etiologia , Fumar Tabaco/efeitos adversos , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Pré-Escolar , Cotinina/sangue , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Masculino , Mães , Gravidez , Terceiro Trimestre da Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Risco , Fatores Sexuais , Fumar Tabaco/epidemiologia
7.
Codas ; 31(6): e20180197, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31778423

RESUMO

PURPOSE: This study aimed to characterize and compare the use of typical story grammar elements and global coherence level in the oral narrative of children with Attention Deficit Hyperactivity Disorder with the narrative of children without the disorder and with typical development. METHODS: A total of 40 children of both sexes aged 5 to 10 years who attended elementary school participated in the study, 20 of whom were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD Group), and 20 with typical development (TD Group). Participants from each group were similar in sex, chronological age, schooling and socioeconomic status. The wordless picture book Frog, Where Are You? was used to elicit the oral narrative analyzed for the presence of the main typical elements of the story schema (character, theme/topic, event/plot and outcome), and afterwards their narration was classified according to four different levels of organization corresponding to the global story coherence level. RESULTS: The ADHD Group presented lower scores on the structural elements "theme/ topic" and "outcome" and a narrative with lower degree of coherence compared to the TD Group. CONCLUSION: The children with ADHD included in this study presented difficulties to use typical story grammar elements, mainly related to the maintenance of the central theme and outcome of the story. These elements are considered fundamental for construction of narrative coherence, which justifies the lower levels of global coherence found in the oral narrative of the ADHD Group.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos do Desenvolvimento da Linguagem/fisiopatologia , Narração , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Estudos de Casos e Controles , Criança , Linguagem Infantil , Pré-Escolar , Feminino , Humanos , Desenvolvimento da Linguagem , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Linguística , Masculino
8.
Medicine (Baltimore) ; 98(46): e17980, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725664

RESUMO

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) which is characterized by developmentally inappropriate levels of attention, hyperactivity and impulsivity, is considered as the most common neurodevelopmental disorder in childhood. Physical exercise has shown to have several benefits in the improvement of children with ADHD. In this meta-analysis, we aimed to systematically show, with evidence, the impact of physical exercise on children with ADHD. METHODS: Web of Science, MEDLINE, EMBASE, Google Scholar, Cochrane Central and http://www.ClinicalTrials.gov were the searched sources for studies which were based on the impact of physical exercise on children with ADHD. Relevant endpoints were assessed. This evidence based meta-analysis was carried out by the most relevant RevMan 5.3 software. Due to the involvement of continuous data (mean and standard deviation), weight mean difference (WMD) with 95% confidence intervals (CI) were used to represent the final analysis. A significant level of P ≤ .05 was set and a fixed statistical effect model was used throughout the analysis. RESULTS: Fourteen studies with a total number of 574 participants with ADHD were included in this evidenced based meta-analysis. Two hundred and seventy six (276) participants were assigned to the physical activity group whereas 298 participants were assigned to the control group. Results of this analysis showed that anxiety and depression were significantly improved with physical activity in these children with ADHD (WMD: -1.84; 95% CI: [-2.65 - (-1.03)], P = .00001). Hyperactive/impulsive symptoms (WMD: -0.01; 95% CI: [-0.32 - 0.29], P = .93) and inattention symptoms (WMD: -0.22; 95% CI: [-0.51 - 0.08], P = .15) were also improved with physical exercise but the results were not statistically significant. This evidence based analysis showed thought problems (WMD: -3.49; 95% CI: [-5.51 - (-1.47)], P = .0007), social problems (WMD: -5.08; 95% CI: [-7.34 - (-2.82)], P = .0001), and aggressive behaviors (WMD: -3.90; 95% CI: [-7.10 - (-0.70)], P = .02) to have significantly been improved in participants with ADHD who were assigned to physical activity group. CONCLUSIONS: This current meta-analysis showed with evidence, that physical exercise has a major contribution owing to significant improvement in anxiety and depression, aggressive behaviors, thought and social problems among children suffering from ADHD. Therefore, physical exercise should be incorporated in the daily life of children with ADHD. Further future research should be able to confirm this hypothesis.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Exercício Físico/fisiologia , Agressão/fisiologia , Ansiedade/etiologia , Ansiedade/terapia , Atenção/fisiologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Depressão/etiologia , Depressão/terapia , Humanos , Relações Interpessoais , Saúde Mental
9.
Handb Clin Neurol ; 163: 351-367, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31590741

RESUMO

Development of the frontal lobe is critical to acquisition, execution, and control of a wide range of functions, from basic motor response to complex decision-making. These functions are influenced by contingency-based (e.g., reward and response-cost/punishment) feedback that is mediated through the adaptive integration of fronto-subcortical neural circuitry. The frontal lobe manages incoming information and chooses the appropriate action based on one's goals in a particular context. This aspect of frontal function, while only one component, is crucial to development and maintenance of approach and avoidance behavior central to all human (and animal) behavior. Furthermore, disruptions in fronto-subcortical circuitry governing motivated behavior appear to contribute to a range of developmental disorders, including attention-deficit/hyperactivity disorder (ADHD), and confer vulnerability for psychopathology more broadly. The particular deficits that manifest in altered behavior depend upon the specific circuitry that is compromised due to the functional specificity of distinct regions of the frontal lobe and its interconnections with subcortical structures. Neurobiologic models of motivated behavior provide a valuable framework for characterizing developmental disorders from a transdiagnostic dimensional systems perspective. Improved characterization of approach and avoidance motivation across neurodevelopmental disorders has the potential to inform the development of novel interventions and personalized medicine.


Assuntos
Lobo Frontal/crescimento & desenvolvimento , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Mapeamento Encefálico , Lobo Frontal/fisiopatologia , Humanos , Motivação/fisiologia
10.
Nat Hum Behav ; 3(12): 1306-1318, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31591521

RESUMO

Most psychopathological disorders develop in adolescence. The biological basis for this development is poorly understood. To enhance diagnostic characterization and develop improved targeted interventions, it is critical to identify behavioural symptom groups that share neural substrates. We ran analyses to find relationships between behavioural symptoms and neuroimaging measures of brain structure and function in adolescence. We found two symptom groups, consisting of anxiety/depression and executive dysfunction symptoms, respectively, that correlated with distinct sets of brain regions and inter-regional connections, measured by structural and functional neuroimaging modalities. We found that the neural correlates of these symptom groups were present before behavioural symptoms had developed. These neural correlates showed case-control differences in corresponding psychiatric disorders, depression and attention deficit hyperactivity disorder in independent clinical samples. By characterizing behavioural symptom groups based on shared neural mechanisms, our results provide a framework for developing a classification system for psychiatric illness that is based on quantitative neurobehavioural measures.


Assuntos
Ansiedade/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Depressão/diagnóstico por imagem , Função Executiva , Adolescente , Anisotropia , Ansiedade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Encéfalo/fisiopatologia , Correlação de Dados , Depressão/fisiopatologia , Transtorno Depressivo/diagnóstico por imagem , Transtorno Depressivo/fisiopatologia , Imagem de Tensor de Difusão , Feminino , Neuroimagem Funcional , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Tamanho do Órgão , Substância Branca/diagnóstico por imagem , Adulto Jovem
11.
J Consult Clin Psychol ; 87(11): 1030-1042, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31613137

RESUMO

OBJECTIVE: Sluggish cognitive tempo refers to a constellation of symptoms that include slowed behavior/thinking, reduced alertness, and getting lost in one's thoughts. Despite the moniker "sluggish cognitive tempo," the evidence is mixed regarding the extent to which it is associated globally with slowed (sluggish) mental (cognitive) information processing speed (tempo). METHOD: A well-characterized clinical sample of 132 children ages 8-13 years (M = 10.34, SD = 1.51; 47 girls; 67% White/non-Hispanic) were administered multiple, counterbalanced neurocognitive tests and assessed for sluggish cognitive tempo symptoms via multiple-informant reports. RESULTS: Bayesian linear regressions revealed significant evidence against associations between sluggish cognitive tempo and computationally modeled processing speed (BF01 > 3.70), and significant evidence for associations with slower working memory manipulation speed. These findings were consistent across parent and teacher models, with and without control for attention-deficit/hyperactivity disorder inattentive symptoms and IQ. There was also significant evidence linking faster inhibition speed with higher parent-reported sluggish cognitive tempo symptoms. CONCLUSIONS: These findings provide strong evidence against characterizing children with sluggish cognitive tempo symptoms as possessing a globally sluggish cognitive tempo. Instead, these symptoms appear to be related, to a significant extent, to executive dysfunction characterized by working memory systems that are too slow and inhibition systems that are too fast. Behaviorally, these findings suggest that requiring extra time to rearrange the active contents of working memory delays responding, whereas an overactive inhibition system likely terminates thoughts too quickly and therefore prevents intended behaviors from starting or completing, thereby giving the appearance that children are absent-minded or failing to act when expected. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos Cognitivos/complicações , Transtornos Cognitivos/fisiopatologia , Memória de Curto Prazo , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Teorema de Bayes , Criança , Transtornos Cognitivos/psicologia , Feminino , Humanos , Masculino , Fatores de Tempo
12.
Optom Vis Sci ; 96(9): 655-663, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31479020

RESUMO

SIGNIFICANCE: Attention-deficit/hyperactivity disorder (ADHD) has been commonly associated with alterations in visual perception. However, the individual behavior of visual perceptual skills and its relationship with different comorbidities remain unknown. PURPOSE: The purpose of this study was to examine whether visual perceptual skills are impaired in children with ADHD, as well as to test the possible mediating role of comorbidities. METHODS: Thirty-five nonmedicated ADHD (20 pure and 15 with comorbidities) and 35 age-matched controls completed the performance-based Test of Visual Perceptual Skills. RESULTS: The analysis between total ADHD and controls favored the alternative hypothesis (greater values for children with ADHD) for visual memory, spatial relationships, sequential memory, and all the composite measures (Bayes factor [BF] range, 4.26 to 366.85). The analysis between pure ADHD and controls showed that data are more likely under the alternative hypothesis for spatial relationships, sequential memory, overall, basic, and sequencing (BF range, 3.82 to 21.71), whereas the comparison between ADHD with comorbidities and controls additionally favored the alternative hypothesis for visual discrimination (BF = 5.37). Lastly, data from the comparison between pure ADHD and ADHD with comorbidities were insensitive for favoring the null or alternative hypotheses in any subtest or composite scaled score (BF range, 0.33 to 0.66). CONCLUSIONS: Our results suggest that some specific patterns of visual perception are altered in ADHD, especially for the total ADHD group. The current findings also evidence that comorbidities play an important role in the association between ADHD and visual perceptual skills. Future studies should address the mediating role of each specific type of comorbidity.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos da Percepção/fisiopatologia , Percepção Visual/fisiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Comorbidade , Feminino , Humanos , Masculino , Memória , Transtornos da Percepção/epidemiologia
13.
Biomed Pharmacother ; 118: 109033, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31545235

RESUMO

Studies suggest that abnormal neurodevelopment of prefrontal striatal circuits is implicated in the pathogenesis of attention deficit hyperactivity disorder (ADHD). In the present study, we investigated the effect of catalpol, an active ingredient of Rehmanniae radix preparata, which is the most frequently used Chinese medicinal herb for the treatment of ADHD, on behavior and neurodevelopment in spontaneously hypertensive rats (SHR). SHR were divided into SHR group (vehicle, i.g.), methylphenidate (MPH) group (2 mg/kg/day, i.g.), and catalpol group (50 mg/kg/day i.g.), and Wistar-Kyoto (WKY) rats were used as control group (vehicle, i.g.). Open Field Test (OFT) and Morris water maze (MWM) test were performed to assess the effect of catalpol on behavior. Results revealed that both catalpol and MPH treatment decreased average speed, time spent in the central area, rearing times, and central area visits, increased the immobility time of SHR in OFT, and increased number of visits to the annulus, and time spent in target quadrant in the MWM test. Hematoxylin and eosin (H&E) staining showed that catalpol reduced irregular neuronal arrangement, ruptured nuclear membranes, and resulted in disappearance of the nucleolus in the prefrontal cortex (PFC) and striatum of SHR. Moreover, immuno-fluorescent staining of NeuN and myelin basic protein (MBP) indicated that catalpol ameliorated neuronal loss and contributed to myelination. Finally, western blot and immunostaining analysis suggested that several regulatory proteins involved in PFC development were up-regulated by catalpol treatment, such as brain-derived neurotrophic factor (BDNF), cyclin-dependent kinase 5 (Cdk5), p35, fibroblast growth factor (FGF) 21 and its receptor (FGFR)1. Taken together, catalpol can effectively ameliorate hyperactive and impulsive behavior, improve spatial learning and memory in SHR, likely through the neurodevelopmental pathways. Nonetheless, whether catalpol could attenuate inattention in SHR and the pathway by which catalpol reduces neuronal loss remain to be further studied.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Comportamento Animal/efeitos dos fármacos , Glucosídeos Iridoides/uso terapêutico , Atividade Motora/efeitos dos fármacos , Fármacos Neuroprotetores/uso terapêutico , Animais , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Estimulantes do Sistema Nervoso Central/uso terapêutico , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/patologia , Modelos Animais de Doenças , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Memória/efeitos dos fármacos , Metilfenidato/uso terapêutico , Neurônios/efeitos dos fármacos , Neurônios/patologia , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/patologia , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY
14.
Muscle Nerve ; 60(6): 732-738, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31520483

RESUMO

INTRODUCTION: Myotonic dystrophy type 1 (DM1) is caused by a CTG (cytosine-thymine-guanine) trinucleotide repeat expansion. Congenital DM (CDM) presents in the first month of life, whereas individuals with infantile and juvenile DM1 have later onset of symptoms. METHODS: We performed a retrospective chart review of patients with childhood-onset DM1 seen at one of three locations in Dallas, Texas between 1990 and 2018. Symptoms, disease course, cognitive features, and family history were reviewed. RESULTS: Seventy-four patients were included; CDM was diagnosed in 52 patients. There was maternal inheritance in 74% of patients. CTG repeat number ranged from 143 to 2300. Neuropsychiatric and cognitive deficits were common. Over half of the patients had GI disturbances, and orthopedic complications were common. DISCUSSION: Myotonic dystrophy type 1 in children requires a multidisciplinary approach to management. Presenting symptoms vary, and repeat expansion size does not necessarily directly relate to severity of symptoms. A consensus for outcome measures is required.


Assuntos
Distrofia Miotônica/fisiopatologia , Asma/etiologia , Asma/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Doença do Sistema de Condução Cardíaco/etiologia , Doença do Sistema de Condução Cardíaco/fisiopatologia , Criança , Pré-Escolar , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Constipação Intestinal/etiologia , Constipação Intestinal/fisiopatologia , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Deficiências do Desenvolvimento/etiologia , Deficiências do Desenvolvimento/fisiopatologia , Feminino , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/fisiopatologia , Humanos , Lactente , Recém-Nascido , Masculino , Herança Materna , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/fisiopatologia , Transtornos do Humor/etiologia , Transtornos do Humor/fisiopatologia , Distrofia Miotônica/complicações , Distrofia Miotônica/genética , Miotonina Proteína Quinase/genética , Estudos Retrospectivos , Expansão das Repetições de Trinucleotídeos
15.
IET Syst Biol ; 13(5): 260-266, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31538960

RESUMO

Attention deficit hyperactivity disorder (ADHD) is a common behavioural disorder that may be found in 5%-8% of the children. Early diagnosis of ADHD is crucial for treating the disease and reducing its harmful effects on education, employment, relationships, and life quality. On the other hand, non-linear analysis methods are widely applied in processing the electroencephalogram (EEG) signals. It has been proved that the brain neuronal activity and its related EEG signals have chaotic behaviour. Hence, chaotic indices can be employed to classify the EEG signals. In this study, a new approach is proposed based on the combination of some non-linear features to distinguish ADHD from normal children. Lyapunov exponent, fractal dimension, correlation dimension and sample, fuzzy and approximate entropies are the non-linear extracted features. For computing, the chaotic time series of obtained EEG in the brain frontal lobe (FP1, FP2, F3, F4, and Fz) need to be analysed. Experiments on a set of EEG signal obtained from 50 ADHD and 26 normal cases yielded a sensitivity, specificity, and accuracy of 98, 92.31, and 96.05%, respectively. The obtained accuracy provides a significant improvement in comparison to the other similar studies in identifying and classifying children with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Eletroencefalografia , Dinâmica não Linear , Processamento de Sinais Assistido por Computador , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Encéfalo/fisiopatologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino
16.
Complement Ther Clin Pract ; 36: 170-175, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31383435

RESUMO

BACKGROUND AND PURPOSE: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common health disorders among children. Some patients do not respond to methylphenidate or cannot tolerate its side effects. Sweet almond syrup as a Persian Medicine preparation has been used for many years. This study aims to evaluate the efficacy and safety of sweet almond for ADHD children. MATERIALS AND METHODS: Fifty children aged 6-14 years with ADHD were recruited to the study. The participants were randomly assigned to two groups to receive either methylphenidate or sweet almond syrup. The outcomes were assessed using the Parent and Teacher ADHD Rating Scale every two weeks for 8 weeks. RESULTS: Results showed that the two treatments had similar effects on symptom reduction in ADHD children. No significant differences were observed between the two groups (F=2.3, df=1, p=0.13, F=0.57, df=1, p=0.47). CONCLUSION: Sweet almond may be an effective treatment for ADHD children.


Assuntos
Antioxidantes/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Metilfenidato/uso terapêutico , Extratos Vegetais/uso terapêutico , Prunus dulcis , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Método Duplo-Cego , Feminino , Alimento Funcional , Humanos , Masculino
17.
Percept Mot Skills ; 126(6): 1101-1116, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31387453

RESUMO

Social anxiety disorder is characterized by a marked fear and avoidance of social situations or a fear of being evaluated by others. Although training for top-down attentional control has been an effective treatment for social anxiety disorder, few studies have demonstrated that individuals with social anxiety have top-down attentional dysfunction. This study used dichotic listening (DL) tasks to investigate the relationship between social anxiety and top-down attentional control over relevant brain activities. We also investigated relationships between both social situation-dependent self-focused attention and external attention bias and situation-independent attentional control. Thirty-six healthy participants underwent near-infrared spectroscopy scanning while performing top-down selective and divided attention DL tasks. Then, they undertook a speech task and completed a questionnaire to assess the degrees of their self-focused attention and external attention bias. The results showed that the degree of social fear and self-focused attention during the speech task were negatively correlated with scores on the selective attention task and with the activity of the left pars opercularis during the selective DL task, which were related to each other. These results suggest that a relationship exists between social fear, self-focused attention in a social situation, and top-down selective attentional dysfunction as assessed both behaviorally and by brain activity changes.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Atenção/fisiologia , Viés de Atenção/fisiologia , Córtex Cerebral/fisiopatologia , Controle Interno-Externo , Fobia Social/fisiopatologia , Autoimagem , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Área de Broca/fisiopatologia , Testes com Listas de Dissílabos , Feminino , Humanos , Masculino , Fobia Social/psicologia , Espectroscopia de Luz Próxima ao Infravermelho , Adulto Jovem
18.
Cyberpsychol Behav Soc Netw ; 22(9): 588-596, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31441667

RESUMO

This study examined both children with attention deficit hyperactivity disorder (ADHD) and typically developing students in dynamic measures of intelligence through the use of a virtual avatar. Three conditions were compared: in the first condition, the avatar simply gave the instructions; in the second condition, the avatar presented the instructions and gave feedback on the attention of the learner; in the third condition, the avatar was not presented. Results indicated that ADHD subtypes do not differ in problem solving and the interactive avatar improved the performance of groups with ADHD in the dynamic intelligence test. Overall, these results support the hypothesis that the function of regulation and feedback of the avatar improve the attention process and, consequently, boosts performance.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Retroalimentação , Testes de Inteligência , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Humanos
19.
Clin EEG Neurosci ; 50(5): 332-338, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31304784

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder and is characterized by symptoms of inattention and/or hyperactivity and impulsivity. In the current study, we obtained quantitative EEG (QEEG) recordings of 51 children aged between 6 and 12 years before the initiation of methylphenidate treatment. The relationship between changes in the scores of ADHD symptoms and initial QEEG features (power/power ratios values) were assessed. In addition, the children were classified as responder and nonresponder according to the ratio of their response to the medication (>25% improvement after medication). Logistic regression analyses were performed to analyze the accuracy of QEEG features for predicting responders. The findings indicate that patients with increased delta power at F8, theta power at Fz, F4, C3, Cz, T5, and gamma power at T6 and decreased beta powers at F8 and P3 showed more improvement in ADHD hyperactivity symptoms. In addition, increased delta/beta power ratio at F8 and theta/beta power ratio at F8, F3, Fz, F4, C3, Cz, P3, and T5 showed negative correlations with Conners' score difference of hyperactivity as well. This means, those with greater theta/beta and delta/beta powers showed more improvement in hyperactivity following medication. Theta power at Cz and T5 and theta/beta power ratios at C3, Cz, and T5 have significantly classified responders and nonresponders according to the logistic binary regression analysis. The results show that slow and fast oscillations may have predictive value for treatment response in ADHD. Future studies should seek for more sensitive biomarkers.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Encéfalo/efeitos dos fármacos , Eletroencefalografia/efeitos dos fármacos , Metilfenidato/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Ritmo beta/efeitos dos fármacos , Ritmo beta/fisiologia , Encéfalo/fisiopatologia , Criança , Cognição/efeitos dos fármacos , Cognição/fisiologia , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Ritmo Teta/efeitos dos fármacos , Ritmo Teta/fisiologia
20.
Neuropsychology ; 33(8): 1065-1077, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31343233

RESUMO

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) in adulthood is associated with problems in multiple domains of everyday life, including financial decision-making (FDM). Research on FDM in adults with ADHD is, however, limited and FDM has never been examined in an objective standardized manner in these patients. The aim of the present study is to explore FDM abilities of adults with ADHD, using both subjective and standardized objective measures. METHOD: Adults with ADHD (n = 45) and healthy controls (n = 51) completed a comprehensive test battery, including an evaluation of their personal financial situation, a neuropsychological assessment and standardized tests and questionnaires measuring various aspects of FDM. RESULTS: Adults with ADHD reported to have a significantly poorer financial situation than healthy controls, including having less income, more often debts and less often a savings account. Furthermore, adults with ADHD showed significantly lower scores than healthy controls in standardized tests measuring financial competence and capacity (i.e., understanding bank statements/protocols and evaluating financial problems) as well as in a test measuring decision making with implications for the future. Furthermore, compared with healthy controls, adults with ADHD reported more often to buy on impulse and to use an avoidant or spontaneous decision-making style. A mediating effect of numeracy was found for 2 measures of FDM (i.e., financial competence and capacity); however, group differences on these measures remained statistically significant. CONCLUSIONS: Adults with ADHD have difficulties with several aspects of FDM. These difficulties may at least partly explain the poorer financial situation of adults with ADHD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Tomada de Decisões/fisiologia , Fatores Socioeconômicos , Adulto , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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