Background Raising a child with attention deficit hyperactivity disorder(ADHD)is a key challenge for the primary caregiver.This systematic review aims to identify major burdens facing the primary caregiver of a child ...Background Raising a child with attention deficit hyperactivity disorder(ADHD)is a key challenge for the primary caregiver.This systematic review aims to identify major burdens facing the primary caregiver of a child with ADHD.Methods The electronic databases CINAHL,PubMed,and Google Scholar were searched for studies published in English from 2017 to 2022 assessing the challenges facing caregivers of a child with ADHD.The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess quality and risk of bias of studies identified for inclusion.Articles were synthesized by evaluating principal themes of burden to caregivers,stress of caregivers,and effectiveness of intervention programs.Results Eleven articles were included in this review and included a total of 2426 participants.Findings revealed that caregivers of children with ADHD have a poor quality of life and high stress levels.Supportive parenting programs can be effective for improved coping and adaptation mechanisms with children with ADHD.However,few interventional studies were identified,increasing potential for bias.No meta-analysis was conducted.Conclusion Caregivers of children with ADHD can benefit from strategies to improve their quality of life and reduce their stress levels.Targeted parenting programs can make a positive difference in the well-being of caregivers and children with ADHD.Additional research is needed to address the evidence-based effectiveness of parenting support programs.展开更多
The prevalence of autism and attention deficit/hyperactivity disorders is increasing worldwide.Recent studies suggest the excessive intake of ultra-processed food plays a role in the inheritance of these disorders via...The prevalence of autism and attention deficit/hyperactivity disorders is increasing worldwide.Recent studies suggest the excessive intake of ultra-processed food plays a role in the inheritance of these disorders via heavy metal exposures and nutritional deficits that impact the expression of genes.In the case of the metallothionein(MT)gene,biomarker studies show dietary zinc(Zn)deficits impact MT protein levels in children with autism and are associated with the bioaccumulation of lead and/or mercury in children exhibiting autism/attention deficit/hyperactivity disorders symptomology.The impact of dietary changes on lead and mercury exposures and MT gene behavior could be determined using a randomized test and control group design.Pregnant women serving in the testgroup would participate in a nutritional epigenetics education intervention/course designed to reduce ultra-processed food intake and heavy metal levels in blood while increasing whole food intake and MT and Zn levels.Changes in maternal diet would be measured using data derived from an online diet survey administered to the test and control groups pre-post intervention.Changes in maternal lead,mercury,Zn,and MT levels would be measured via blood sample analyses prior to the intervention and after childbirth via cord blood analyses to determine infant risk factors.展开更多
Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment ...Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.展开更多
BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a prevalent neurodevelopmental disorder in adolescents characterized by inattention,hyperactivity,and impulsivity,which impact cognitive,behavioral,and emoti...BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a prevalent neurodevelopmental disorder in adolescents characterized by inattention,hyperactivity,and impulsivity,which impact cognitive,behavioral,and emotional functioning.Resting-state functional magnetic resonance imaging(rs-fMRI)provides critical insights into the functional architecture of the brain in ADHD.Despite extensive research,specific brain regions consistently affected in ADHD patients during these formative years have not been comprehensively delineated.AIM To identify consistent vulnerable brain regions in adolescent ADHD patients using rs-fMRI and activation likelihood estimation(ALE)meta-analysis.METHODS We conducted a comprehensive literature search up to August 31,2024,to identify studies investigating functional brain alterations in adolescents with ADHD.We utilized regional homogeneity(ReHo),amplitude of low-frequency fluctuations(ALFF),dynamic ALFF(dALFF)and fractional ALFF(fALFF)analyses.We compared the regions of aberrant spontaneous neural activity in adolescents with ADHD with those in healthy controls(HCs)using ALE.RESULTS Fifteen studies(468 adolescent ADHD patients and 466 HCs)were included.Combining the ReHo and ALFF/fALFF/dALFF data,the results revealed increased activity in the right lingual gyrus[LING,Brodmann Area(BA)18],left LING(BA 18),and right cuneus(CUN,BA 23)in adolescent ADHD patients compared with HCs(voxel size:592-32 mm³,P<0.05).Decreased activity was observed in the left medial frontal gyrus(MFG,BA 9)and left precuneus(PCUN,BA 31)in adolescent ADHD patients compared with HCs(voxel size:960-456 mm³,P<0.05).Jackknife sensitivity analyses demonstrated robust reproducibility in 11 of the 13 tests for the right LING,left LING,and right CUN and in 11 of the 14 tests for the left MFG and left PCUN.CONCLUSION We identified specific brain regions with both increased and decreased activity in adolescent ADHD patients,enhancing our understanding of the neural alterations that occur during this pivotal stage of development.展开更多
BACKGROUND Attention deficit hyperactivity disorder(ADHD)affects approximately 5%of children worldwide and is associated with significant academic impairment.Parents of children with ADHD experience elevated stress an...BACKGROUND Attention deficit hyperactivity disorder(ADHD)affects approximately 5%of children worldwide and is associated with significant academic impairment.Parents of children with ADHD experience elevated stress and anxiety levels,which may further affect their children's educational outcomes.This prospective study examined the relationship between parental anxiety and academic performance of children with ADHD over a 6-year period.AIM To investigate the longitudinal impact of parental anxiety on academic performance in children with ADHD and explore the mediating and moderating factors over a 6-year follow-up period.METHODS A longitudinal cohort study was conducted from 2018 to 2024,enrolling 118 children with ADHD(aged 6-12 years)and their parents from three specialized educational centers.Parental anxiety was assessed using the Parenting Stress Index-4(PSI-4)and Parental Anxiety Scale.Children's academic performance was measured using the Academic Performance Questionnaire and standardized achievement tests.Assessments were conducted at baseline and every 6 months for 3 years.RESULTS Higher parental anxiety scores were significantly associated with poorer academic performance in children with ADHD(β=-0.42,P<0.001).Children of parents with clinically significant anxiety(PSI-4 scores>85th percentile)showed 1.2 standard deviations lower academic achievement than children of parents with normal anxiety levels.The relationship was partially mediated by parent-child interaction quality(indirect effect=-0.18,95%CI:-0.26 to-0.10)and homework supervision practices(indirect effect=-0.15,95%CI:-0.22 to-0.08).CONCLUSION Parental anxiety could significantly affect the academic outcomes of children with ADHD via multiple pathways.Interventions targeting parental mental health may improve the educational outcomes of children with ADHD.展开更多
The study investigated the effects of monetary rewards and punishments on the behavioral inhibition in children with attention deficit hyperactivity disorder(ADHD)tendencies.The present study adopted the signal stoppi...The study investigated the effects of monetary rewards and punishments on the behavioral inhibition in children with attention deficit hyperactivity disorder(ADHD)tendencies.The present study adopted the signal stopping task paradigm,with 66 children with ADHD tendencies as the research subjects.A mixed design of 2(reward and punishment type:reward,punishment)×2(stimulus type:monetary stimulus,social stimulus)was used.The analysis applied a between intervention group(with reward and punishment type variables)and within type of reward approach(by stimulus type as intra subject variables).The results showed that monetary punishment better promotes behavioral inhibition in children with an ADHD tendency than does reward.In addition,this study showed that monetary punishment and social rewards affected the speed–accuracy trade-off of inhibited behavior in children with an ADHD tendency.Thesefindings suggest that withdrawal of a material token resulted in more behavioural compliance in children with an ADHD tendency.展开更多
BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ...BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.AIM To investigate whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.METHODS The population-based National Health Insurance Research Database in Taiwan was used.Hazards of subsequent psychiatric disorders were compared between those who received ST and a propensity-score matched comparison group by Cox regression analyses.RESULTS Of 11987 children with ADHD identified from the dataset,2911(24%)had received ST.The adjusted hazard ratio for any subsequent recorded psychiatric disorder was 0.72(95%confidence interval:0.63-0.82)in children who received ST compared to the matched counterparts.This protective association was only statistically significant in the subgroup that received both medication and behavioral interventions.CONCLUSION ST can moderate the effects of integrated early interventions in ADHD children with speech delay.展开更多
The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（A...The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.展开更多
Attention deficit hyperactivity disorder （ADHD） is one of the most common mental disorders in childhood, with a high heritability about 60% to 90%. Serotonin is a monoamine neurotransmitter. Numerous studies have re...Attention deficit hyperactivity disorder （ADHD） is one of the most common mental disorders in childhood, with a high heritability about 60% to 90%. Serotonin is a monoamine neurotransmitter. Numerous studies have reported the association between the serotonin receptor family （5-HTR） gene polymorphisms and ADHD, but the results are still controversial. In this study, we conducted a meta-analysis of the association between 5-HTRIB, 5-HTR2A, and 5-HTR2C genetic variants and ADHD. The results showed that the 861G allele of 5-HTRIB SNP rs6296 could significantly increase the risk of ADHD （OR= 1.09, 95% CI： 1.01-1.18）; the 5-HTR2C gene rs518147 （OR=1.69, 95% CI： 1.38-2.07） and rs3813929 （OR = 1.57, 95% CI： 1.25-1.97） were all associated with the risk of ADHD. In addition, we also carried on a case- control study to explore the relevance between potential candidate genes 5-HTR1A, 5-HTRIE, 5-HTR3A and ADHD. The results indicated that 5-HTRIA rs6295 genotype （CC＋CG vs. GG OR=Z00, 95% CI： 1.23-3.27） and allele （OR=1.77, 95% CI： 1.16-2.72） models were statistically significantly different between case group and control group. This study is the first comprehensive exploration and summary of the association between serotonin receptor family genetic variations and ADHD, and it also provides more evidence for the etiology of ADHD.展开更多
Objective： To test the neural electrophysiological basis of acupuncture treatment on attention deficit of insomnia patients.Methods： Thirty insomnia attention deficit patients were enrolled as the patient group in t...Objective： To test the neural electrophysiological basis of acupuncture treatment on attention deficit of insomnia patients.Methods： Thirty insomnia attention deficit patients were enrolled as the patient group in this study, and30 normal people were collected as the normal group as the compare. In patient group, acupuncture was adopted and the acupoints were Bǎihui（百会GV20）, Shéntíng（神庭 GV24）, Sìshéncōng（四神聪 EX-HN1）,Shenmen（神门 HT7） and Sānyīnjiāo（三阴交 SP6）, even reinforcing and reducing method, once a day, 10 times as a course and totally 2 courses. There was no intervention for the normal group. Pittsburg Sleep Quality Index（PSQI） for assessing the sleep quality, Schulte grid scale and the event-related potential（ERP） for assessing the attention deficit were evaluated before the treatment, 10 days after the treatment and after the treatment. The normal group were taken evaluation at the same time point.Results： 1. PSQI. The PSQI score in the patient group before the treatment was（16.20 ±2.02） and was（4.20 ±1.64） after the treatment. The difference was statistically significant（P0.05）. The normal group was（4.00 ± 1.52） at the same point after the treatment, and the differences was not statistically significant（P〈0.05）. 2. Schulte grid scale. The Schulte grid scale rating score was decrease from（32.87 ± 6.71）s before the treatment to（12.82 ±3.40） s after the treatment, and the difference was statistically significant（P〈0.05）. The normal group was（12.29 ± 3.47） s at the same point after the treatment, and the differences was not statistically significant（P〈0.05）. 3. ERP.（1） P300： in the patient group, the latency of P3 a decreased from（316.60 ± 18.42） ms before the treatment to（300.10 ± 12.03） ms after the treatment;the latency of P3 b decreased from（328.32 士 16.32） ms before the treatment to（304.63 ± 13.248） ms after the treatment; the amplitude of P3 a increased from（5.501.16） μV before the treatment to（15.20 士 2.12）μV after the treatment; the amplitude of P3 b increased from（5.76 士 1.87） μV before the treatment to（16.76 ± 2.37） μV after the treatment, and the differences were statistically significant（all P〈0.05）.（2）CNV： in the patient group, the latency of point A decreased from（404 ±129） ms before the treatment to（369 ± 105） ms after the treatment; the latency of point C decreased from（2584 ± 563） ms before the treatment to（2308 士 369） ms after the treatment; the amplitude of A-B increased from（10.3 ±17.4）μV before the treatment to（13.7 ±24.8） μV after the treatment, and the differences were statistically significant（all P〈0.05）.Conclusion： Acupuncture can improve the sleep quality and the attention deficit condition of insomnia attention deficit patients by regulating the nerve electrophysiology of the brain.展开更多
Objective:To explore the effect and mechanism of action of Celastrus paniculatus oil on the treatment of perinatal rats with attention deficit hyperactivity disorder.Methods:In the perinatal stage,the rats were either...Objective:To explore the effect and mechanism of action of Celastrus paniculatus oil on the treatment of perinatal rats with attention deficit hyperactivity disorder.Methods:In the perinatal stage,the rats were either isolated or administered with lead acetate to establish an animal model of attention deficit hyperactivity disorder.Atomoxetine served as the reference standard.Animals’behaviours were assessed through Y-maze,novel object preference,fear conditioning and residentintruder aggression tests.Oxidative stress parameters,bioamine concentration(dopamine,noradrenaline and 5-hydroxytryptamine),nerve growth factor,interleukin-6,nuclear factor-κB,and tumour necrosis factor(TNF)-αwere estimated.Synaptophysin immunohistochemical assay was performed.Results:Celastrus paniculatus oil significantly improved behavioural parameters in Y maze,novel object preference,discrimination index,fear conditioning and resident intruder aggressive tests.The treatment groups showed a decrease in malondialdehyde level.Changes in the levels of dopamine,noradrenaline,and serotonin were restored by Celastrus paniculatus oil.Celastrus paniculatus oil increased nerve growth factor and decreased interleukin-6,nuclear factor-κB,and TNF-α.Synaptophysin immunoreactivity was also improved by Celastrus paniculatus oil with alleviated reactive gliosis,degeneration,and vascular proliferation.Conclusions:This research shows the therapeutic potential of Celastrus paniculatus oil for the treatment of attention deficit hyperactivity disorder.展开更多
Attention deficit and hyperactivity disorder （ADHD）, a prevalent syndrome in children worldwide, is characterized by impulsivity, inappropriate inattention, and/or hyperactivity. It seriously afflicts cognitive deve...Attention deficit and hyperactivity disorder （ADHD）, a prevalent syndrome in children worldwide, is characterized by impulsivity, inappropriate inattention, and/or hyperactivity. It seriously afflicts cognitive development in childhood, and may lead to chronic under-achievement, academic failure, problematic peer relationships, and low self-esteem. There are at least three challenges for the treatment of ADHD. First, the neurobiological bases of its symptoms are still not clear. Second, the commonly prescribed medications, most showing short-term therapeutic efficacy but with a high risk of serious side-effects, are mainly based on a dopamine mechanism. Third, more novel and efficient animal models, especially in nonhuman primates, are required to accelerate the development of new medications. In this article, we review research progress in the related fields, focusing on our previous studies showing that blockade of prefrontal cortical a2A-adrenoceptors in monkeys produces almost all the typical behavioral symptoms of ADHD.展开更多
BACKGROUND Iron plays an important role in neurodevelopmental functions in the brain.Serum ferritin levels are different in children with attention deficit hyperactivity disorder and tic disorder than in healthy child...BACKGROUND Iron plays an important role in neurodevelopmental functions in the brain.Serum ferritin levels are different in children with attention deficit hyperactivity disorder and tic disorder than in healthy children.AIM To explore the current status of iron deficiency in children with neurodevelopmental disorders and its sex and age effects.METHODS A total of 1565 children with attention deficit hyperactivity disorder(ADHD),1694 children with tic disorder(TD),93 children with ASD and 1997 healthy control children were included between January 1,2020,and December 31,2021 at Beijing Children's Hospital.We describe the differences in age levels and ferritin levels between different disease groups and their sex differences.The differences between the sexes in each disease were analyzed using the t test.The incidence rate of low serum ferritin was used to describe the differences between different diseases and different age groups.A chi-square test was used to analyze the difference in the incidence of low serum ferritin between the disease group and the control group.Analysis of variance was used for comparisons between subgroups,and regression analysis was used for confounding factor control.RESULTS A total of 1565 ADHD patients aged 5-12 years were included in this study,and the average serum ferritin levels of male and female children were 36.82±20.64μg/L and 35.64±18.56μg/L,respectively.A total of 1694 TD patients aged 5-12 years were included in this study,and the average serum ferritin levels of male and female children were 35.72±20.15μg/L and 34.54±22.12μg/L,respectively.As age increased,the incidence of low serum ferritin in ADHD and TD first decreased and then increased,and 10 years old was the turning point of rising levels.The incidence of ADHD with low serum ferritin was 8.37%,the incidence of TD with low serum ferritin was 11.04%,and the incidence of the healthy control group with low serum ferritin was 8.61%,among which male children with TD accounted for 9.25%and female children with TD accounted for 11.62%.There was a significant difference among the three groups(P<0.05).In addition,there were 93 children with ASD with an average serum ferritin level of 30.99±18.11μg/L and a serum ferritin incidence of 15.05%.CONCLUSION In conclusion,low serum ferritin is not a risk factor for ADHD or TD.The incidence of low serum ferritin levels in children with ADHD and TD between 5 and 12 years old decreases first and then increases with age.展开更多
BACKGROUND： The core symptoms of attention deficit, impulsiveness, hyperactivity of attention deficit hyperactivity disorders （ADHD） can concurrently present in spontaneous hypertensive rats. Neuropathological, bio...BACKGROUND： The core symptoms of attention deficit, impulsiveness, hyperactivity of attention deficit hyperactivity disorders （ADHD） can concurrently present in spontaneous hypertensive rats. Neuropathological, biochemical and pharmacological studies also support it. Spontaneous hypertensive rats are one kind of best ADHD animal models, which has been accepted at present. Yizhining elixation can reinforce kidney and calm liver, strengthen spleen and nourish heart, benefit intelligence and focus attention, but its therapeutic effect on treatment of ADHD needs to be further investigated. OBJECTIVE： To observe the effect of Yizhining elixation on the persistent active attention deficit and impulsiveness of rats with spontaneous hypertension. DESIGN： Observational and controlled analysis. SETTING： Department of Pediatrics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine. MATERIALS： Thirty-six male rats with spontaneous hypertension, of clean grade, were involved in this experiment. The involved rats were provided by Shanghai SLAC Laboratory Animal Co., Ltd., and they did not undergo any experiments; Yizhining elixation was composed by Guiban, Shenglonggu, Yuanzhi, Shichangpu, Yejiaoteng, Shudi, Dangshen, Yunling, Fuxiaomai, Wueizi. etc. Crude drug, provided by Outpatient Dispensary, Affiliated Hospital of Guangzhou University of Chinese Medicine, was prepared into water elixation, which contained crude drug of 1.154 g/mL. METHODS： This experiment was carried out in the Department of Pediatrics, First Affiliated Hospital of Guangzhou University of Chinese Medicine between March and July 2005. The involved rats were randomized into 3 groups： Yizhining high dose group, Yizhining low dose group and blank control group, with 12 rats in each. Changes in sustained attention and impulsiveness of rats were detected before and after administration of Yizhining elixation by ＂5-choice serial response time task＂ method. Following above-mentioned training and detection, rats in each group were daily drenched with Yizhining elixation once for 14 days successively. Rats in the Yizhining High-dose and low-dose groups we, e drenched with 12.6 mL/kg and 6.3 mL/kg Yizhining elixation （diluted to 25 mL/kg） respectively, and those in the blank control group were drenched with 12.5 mL/kg normal saline. On the 14^th day after administration, the ratios of correct and immature response of rats were re-detected for 3 days successively by formal detection method for later analysis. The sustained attention of rats was evaluated with ratio of correct response： Ratio of correct response=[times of correct response/（times of correct response ＋ times of incorrect response）]; impulsiveness was evaluated with the ratio of immature response： ratio of immature response=[times of immature response/ （times of correct response＋times of incorrect response＋times of omission＋times of immature response） ]. MAIN OUTCOME MEASURES： The effects of different doses of Yizhining elixation on the sustained attention （ratio of correct response） and impulsiveness （ratio of immature response） of spontaneous hypertensive rats. RESULTS： Thirty-six spontaneous hypertensive rats were involved in the final analysis. The ratio of correct response of rats in the Yizhining high dose and low dose groups after administration was （98.9±2.30）% and （96.6±4.00） %, respectively, which was significantly higher than that before administration [ （80.4±11.5 ） %, （839±8.90） %, P 〈 0.01] and that in the blank control group[ （83.3±6.30） %, P 〈 0.01]. The ratio of immature response of rats in the Yizhining high dose and low dose groups after adminisWafion was （5.04 ±1.04 ） %, （7.23 ± 1.22 ） %, respectively, which was lower than that before administration [ （9.85 ±2.50） %, （9.40±1.73 ） %, P 〈 0.05] and that in the blank control group [ （ 9.42 ±1.64） %, P 〈 0.01 ]. CONCLUSION： Yizhining elixation can improve the sustained attention and impulsiveness of spontaneous hypertensive rats.展开更多
In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the eff...In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the effectiveness of electroencephalogram (EEG) biofeedback training. Of all the 60 children with ADHD aged more than 6 years, the effective rate of EEG biofeedback training was 91.6 % after 40 sessions of EEG biofeedback training. Before and after treatment by EEG biofeedback training, the overall indexes of IVA were significantly improved among predominately inattentive, hyperactive, and combined subtype of children with ADHD (P<0.001). It was suggested that EEG biofeedback training was an effective and vital treatment on children with ADHD.展开更多
Attention deficit hyperactivity disorder（ADHD） is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have ex...Attention deficit hyperactivity disorder（ADHD） is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantified using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identified as regions with significant group-wise differences. The identified regions were correlated with clinical scores reflecting depression and anxiety and significant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain circuitry might differentially impact male and female ADHD patients.展开更多
Inappropriate levels of hyperactivity,impulsivity,and inattention characterize attention deficit hyperactivity disorder,a common childhood-onset neuropsychiatric disorder.The cognitive function and learning ability of...Inappropriate levels of hyperactivity,impulsivity,and inattention characterize attention deficit hyperactivity disorder,a common childhood-onset neuropsychiatric disorder.The cognitive function and learning ability of children with attention deficit hyperactivity disorder are affected,and these symptoms may persist to adulthood if they are not treated.The diagnosis of attention deficit hyperactivity disorder is only based on symptoms and objective tests for attention deficit hyperactivity disorder are missing.Treatments for attention deficit hyperactivity disorder in children include medications,behavior therapy,counseling,and education services which can relieve many of the symptoms of attention deficit hyperactivity disorder but cannot cure it.There is a need for a molecular biomarker to distinguish attention deficit hyperactivity disorder from healthy subjects and other neurological conditions,which would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of attention deficit hyperactivity disorder.The recent studies reviewed had performed microRNA profiling in whole blood,white blood cells,blood plasma,and blood serum of children with attention deficit hyperactivity disorder.A large number of microRNAs were dysregulated when compared to healthy controls and with some overlap between individual studies.From the studies that had included a validation set of patients and controls,potential candidate biomarkers for attention deficit hyperactivity disorder in children could be miR-140-3p,let-7g-5p,-30e-5p,-223-3p,-142-5p,-486-5p,-151a-3p,-151a-5p,and-126-5p in total white blood cells,and miR-4516,-6090,-4763-3p,-4281,-4466,-101-3p,-130a-3p,-138-5p,-195-5p,and-106b-5p in blood serum.Further studies are warranted with children and adults with attention deficit hyperactivity disorder,and consideration should be given to utilizing rat models of attention deficit hyperactivity disorder.Animal studies could be used to confirm microRNA findings in human patients and to test the effects of targeting specific microRNAs on disease progression and behavior.展开更多
Objectives:Compare and relate the performance of schoolchildren with Attention Deficit Hyperactivity Disorder(ADHD)and with good academic performance in the visual-motor perceptual and reading processes.Method:Twenty ...Objectives:Compare and relate the performance of schoolchildren with Attention Deficit Hyperactivity Disorder(ADHD)and with good academic performance in the visual-motor perceptual and reading processes.Method:Twenty schoolchildren,of both genders,aged between nine and 11 years old,participated in this study.They were divided into two groups:Group I(GI):comprising 10 students diagnosed with ADHD;and Group II(GII):10 students with good academic performance paired according to gender,age group,and educational level with GI.All students were submitted to the Developmental Test of Visual Perception(DTVP 3)and Reading Processes Assessment Protocol(PROLEC).Results:There was lower performance of GI compared to GII in the subtests of copying,eye-hand coordination,and figure-ground in the standard score of general visual perception and visual-motor integration.GI presented lower performance in all reading processes except for the punctuation marks test.There was a statistically significant difference in the comparison between GI and GII regarding the classification of reading processes.A relationship was identified between the reading and visual perception subtests in the GI students,demonstrating a relationship between the visual perceptual motor skills and the reading processes in the group of students with ADHD.Conclusion:Schoolchildren with ADHD performed less well than their peers with good academic performance in the visual-motor perceptual and reading skills;such that the worse their performance in the visual-motor perceptual processes,the worse their performance in the reading processes.展开更多
BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medicati...BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.展开更多
Attention deficit and hyperactivity disorder（ADHD） is a disorder characterized by behavioral symptoms including hyperactivity/impulsivity among children,adolescents,and adults.These ADHD related symptoms are influen...Attention deficit and hyperactivity disorder（ADHD） is a disorder characterized by behavioral symptoms including hyperactivity/impulsivity among children,adolescents,and adults.These ADHD related symptoms are influenced by the complex interaction of brain networks which were under explored.We explored age-related brain network differences between ADHD patients and typically developing（TD） subjects using resting state f MRI（rs-f MRI） for three age groups of children,adolescents,and adults.We collected rs-f MRI data from 184 individuals（27 ADHD children and 31 TD children;32 ADHD adolescents and 32 TD adolescents;and 31 ADHD adults and 31 TD adults）.The Brainnetome Atlas was used to define nodes in the network analysis.We compared three age groups of ADHD and TD subjects to identify the distinct regions that could explain age-related brain network differences based on degree centrality,a well-known measure of nodal centrality.The left middle temporal gyrus showed significant interaction effects between disease status（i.e.,ADHD or TD） and age（i.e.,child,adolescent,or adult）（P 0.001）.Additional regions were identified at a relaxed threshold（P 0.05）.Many of the identified regions（the left inferior frontal gyrus,the left middle temporal gyrus,and the left insular gyrus） were related to cognitive function.The results of our study suggest that aberrant development in cognitive brain regions might be associated with age-related brain network changes in ADHD patients.These findings contribute to better understand how brain function influences the symptoms of ADHD.展开更多
文摘Background Raising a child with attention deficit hyperactivity disorder(ADHD)is a key challenge for the primary caregiver.This systematic review aims to identify major burdens facing the primary caregiver of a child with ADHD.Methods The electronic databases CINAHL,PubMed,and Google Scholar were searched for studies published in English from 2017 to 2022 assessing the challenges facing caregivers of a child with ADHD.The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess quality and risk of bias of studies identified for inclusion.Articles were synthesized by evaluating principal themes of burden to caregivers,stress of caregivers,and effectiveness of intervention programs.Results Eleven articles were included in this review and included a total of 2426 participants.Findings revealed that caregivers of children with ADHD have a poor quality of life and high stress levels.Supportive parenting programs can be effective for improved coping and adaptation mechanisms with children with ADHD.However,few interventional studies were identified,increasing potential for bias.No meta-analysis was conducted.Conclusion Caregivers of children with ADHD can benefit from strategies to improve their quality of life and reduce their stress levels.Targeted parenting programs can make a positive difference in the well-being of caregivers and children with ADHD.Additional research is needed to address the evidence-based effectiveness of parenting support programs.
文摘The prevalence of autism and attention deficit/hyperactivity disorders is increasing worldwide.Recent studies suggest the excessive intake of ultra-processed food plays a role in the inheritance of these disorders via heavy metal exposures and nutritional deficits that impact the expression of genes.In the case of the metallothionein(MT)gene,biomarker studies show dietary zinc(Zn)deficits impact MT protein levels in children with autism and are associated with the bioaccumulation of lead and/or mercury in children exhibiting autism/attention deficit/hyperactivity disorders symptomology.The impact of dietary changes on lead and mercury exposures and MT gene behavior could be determined using a randomized test and control group design.Pregnant women serving in the testgroup would participate in a nutritional epigenetics education intervention/course designed to reduce ultra-processed food intake and heavy metal levels in blood while increasing whole food intake and MT and Zn levels.Changes in maternal diet would be measured using data derived from an online diet survey administered to the test and control groups pre-post intervention.Changes in maternal lead,mercury,Zn,and MT levels would be measured via blood sample analyses prior to the intervention and after childbirth via cord blood analyses to determine infant risk factors.
基金Supported by the Central Guiding Local Science and Technology Development Fund Project,No.YDZX2022091。
文摘Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.
基金Supported by National Natural Science Foundation of China,No.82460282Guizhou Province Science and Technology Plan Project,No.ZK-2023-195+1 种基金Guizhou High-Level Innovative Talent Project,No.gzwjrs2022-013Health Commission of Guizhou Province Project,No.gzwkj2024-475 and No.gzwkj2021-150.
文摘BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a prevalent neurodevelopmental disorder in adolescents characterized by inattention,hyperactivity,and impulsivity,which impact cognitive,behavioral,and emotional functioning.Resting-state functional magnetic resonance imaging(rs-fMRI)provides critical insights into the functional architecture of the brain in ADHD.Despite extensive research,specific brain regions consistently affected in ADHD patients during these formative years have not been comprehensively delineated.AIM To identify consistent vulnerable brain regions in adolescent ADHD patients using rs-fMRI and activation likelihood estimation(ALE)meta-analysis.METHODS We conducted a comprehensive literature search up to August 31,2024,to identify studies investigating functional brain alterations in adolescents with ADHD.We utilized regional homogeneity(ReHo),amplitude of low-frequency fluctuations(ALFF),dynamic ALFF(dALFF)and fractional ALFF(fALFF)analyses.We compared the regions of aberrant spontaneous neural activity in adolescents with ADHD with those in healthy controls(HCs)using ALE.RESULTS Fifteen studies(468 adolescent ADHD patients and 466 HCs)were included.Combining the ReHo and ALFF/fALFF/dALFF data,the results revealed increased activity in the right lingual gyrus[LING,Brodmann Area(BA)18],left LING(BA 18),and right cuneus(CUN,BA 23)in adolescent ADHD patients compared with HCs(voxel size:592-32 mm³,P<0.05).Decreased activity was observed in the left medial frontal gyrus(MFG,BA 9)and left precuneus(PCUN,BA 31)in adolescent ADHD patients compared with HCs(voxel size:960-456 mm³,P<0.05).Jackknife sensitivity analyses demonstrated robust reproducibility in 11 of the 13 tests for the right LING,left LING,and right CUN and in 11 of the 14 tests for the left MFG and left PCUN.CONCLUSION We identified specific brain regions with both increased and decreased activity in adolescent ADHD patients,enhancing our understanding of the neural alterations that occur during this pivotal stage of development.
文摘BACKGROUND Attention deficit hyperactivity disorder(ADHD)affects approximately 5%of children worldwide and is associated with significant academic impairment.Parents of children with ADHD experience elevated stress and anxiety levels,which may further affect their children's educational outcomes.This prospective study examined the relationship between parental anxiety and academic performance of children with ADHD over a 6-year period.AIM To investigate the longitudinal impact of parental anxiety on academic performance in children with ADHD and explore the mediating and moderating factors over a 6-year follow-up period.METHODS A longitudinal cohort study was conducted from 2018 to 2024,enrolling 118 children with ADHD(aged 6-12 years)and their parents from three specialized educational centers.Parental anxiety was assessed using the Parenting Stress Index-4(PSI-4)and Parental Anxiety Scale.Children's academic performance was measured using the Academic Performance Questionnaire and standardized achievement tests.Assessments were conducted at baseline and every 6 months for 3 years.RESULTS Higher parental anxiety scores were significantly associated with poorer academic performance in children with ADHD(β=-0.42,P<0.001).Children of parents with clinically significant anxiety(PSI-4 scores>85th percentile)showed 1.2 standard deviations lower academic achievement than children of parents with normal anxiety levels.The relationship was partially mediated by parent-child interaction quality(indirect effect=-0.18,95%CI:-0.26 to-0.10)and homework supervision practices(indirect effect=-0.15,95%CI:-0.22 to-0.08).CONCLUSION Parental anxiety could significantly affect the academic outcomes of children with ADHD via multiple pathways.Interventions targeting parental mental health may improve the educational outcomes of children with ADHD.
基金supported by the National General Projects in 2020 of the 13th Five Year Plan of National Education Science in China:A Study on Attention Training Interventions for ADHD Children in Regular Classes from the Perspective of Educational Neuroscience(BHA200123).
文摘The study investigated the effects of monetary rewards and punishments on the behavioral inhibition in children with attention deficit hyperactivity disorder(ADHD)tendencies.The present study adopted the signal stopping task paradigm,with 66 children with ADHD tendencies as the research subjects.A mixed design of 2(reward and punishment type:reward,punishment)×2(stimulus type:monetary stimulus,social stimulus)was used.The analysis applied a between intervention group(with reward and punishment type variables)and within type of reward approach(by stimulus type as intra subject variables).The results showed that monetary punishment better promotes behavioral inhibition in children with an ADHD tendency than does reward.In addition,this study showed that monetary punishment and social rewards affected the speed–accuracy trade-off of inhibited behavior in children with an ADHD tendency.Thesefindings suggest that withdrawal of a material token resulted in more behavioural compliance in children with an ADHD tendency.
文摘BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.AIM To investigate whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.METHODS The population-based National Health Insurance Research Database in Taiwan was used.Hazards of subsequent psychiatric disorders were compared between those who received ST and a propensity-score matched comparison group by Cox regression analyses.RESULTS Of 11987 children with ADHD identified from the dataset,2911(24%)had received ST.The adjusted hazard ratio for any subsequent recorded psychiatric disorder was 0.72(95%confidence interval:0.63-0.82)in children who received ST compared to the matched counterparts.This protective association was only statistically significant in the subgroup that received both medication and behavioral interventions.CONCLUSION ST can moderate the effects of integrated early interventions in ADHD children with speech delay.
基金supported by a Project of Shanghai Municipal Health and Family Planning Commission (201540114)a Key Specialty Project of Shanghai Municipal Health and Family Planning Commission grant for Child Psychiatry (ZK2015B01)a Research Project of the Shanghai Changning Health and Family Planning Commission grant (20164Y013)
文摘The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.
文摘Attention deficit hyperactivity disorder （ADHD） is one of the most common mental disorders in childhood, with a high heritability about 60% to 90%. Serotonin is a monoamine neurotransmitter. Numerous studies have reported the association between the serotonin receptor family （5-HTR） gene polymorphisms and ADHD, but the results are still controversial. In this study, we conducted a meta-analysis of the association between 5-HTRIB, 5-HTR2A, and 5-HTR2C genetic variants and ADHD. The results showed that the 861G allele of 5-HTRIB SNP rs6296 could significantly increase the risk of ADHD （OR= 1.09, 95% CI： 1.01-1.18）; the 5-HTR2C gene rs518147 （OR=1.69, 95% CI： 1.38-2.07） and rs3813929 （OR = 1.57, 95% CI： 1.25-1.97） were all associated with the risk of ADHD. In addition, we also carried on a case- control study to explore the relevance between potential candidate genes 5-HTR1A, 5-HTRIE, 5-HTR3A and ADHD. The results indicated that 5-HTRIA rs6295 genotype （CC＋CG vs. GG OR=Z00, 95% CI： 1.23-3.27） and allele （OR=1.77, 95% CI： 1.16-2.72） models were statistically significantly different between case group and control group. This study is the first comprehensive exploration and summary of the association between serotonin receptor family genetic variations and ADHD, and it also provides more evidence for the etiology of ADHD.
文摘Objective： To test the neural electrophysiological basis of acupuncture treatment on attention deficit of insomnia patients.Methods： Thirty insomnia attention deficit patients were enrolled as the patient group in this study, and30 normal people were collected as the normal group as the compare. In patient group, acupuncture was adopted and the acupoints were Bǎihui（百会GV20）, Shéntíng（神庭 GV24）, Sìshéncōng（四神聪 EX-HN1）,Shenmen（神门 HT7） and Sānyīnjiāo（三阴交 SP6）, even reinforcing and reducing method, once a day, 10 times as a course and totally 2 courses. There was no intervention for the normal group. Pittsburg Sleep Quality Index（PSQI） for assessing the sleep quality, Schulte grid scale and the event-related potential（ERP） for assessing the attention deficit were evaluated before the treatment, 10 days after the treatment and after the treatment. The normal group were taken evaluation at the same time point.Results： 1. PSQI. The PSQI score in the patient group before the treatment was（16.20 ±2.02） and was（4.20 ±1.64） after the treatment. The difference was statistically significant（P0.05）. The normal group was（4.00 ± 1.52） at the same point after the treatment, and the differences was not statistically significant（P〈0.05）. 2. Schulte grid scale. The Schulte grid scale rating score was decrease from（32.87 ± 6.71）s before the treatment to（12.82 ±3.40） s after the treatment, and the difference was statistically significant（P〈0.05）. The normal group was（12.29 ± 3.47） s at the same point after the treatment, and the differences was not statistically significant（P〈0.05）. 3. ERP.（1） P300： in the patient group, the latency of P3 a decreased from（316.60 ± 18.42） ms before the treatment to（300.10 ± 12.03） ms after the treatment;the latency of P3 b decreased from（328.32 士 16.32） ms before the treatment to（304.63 ± 13.248） ms after the treatment; the amplitude of P3 a increased from（5.501.16） μV before the treatment to（15.20 士 2.12）μV after the treatment; the amplitude of P3 b increased from（5.76 士 1.87） μV before the treatment to（16.76 ± 2.37） μV after the treatment, and the differences were statistically significant（all P〈0.05）.（2）CNV： in the patient group, the latency of point A decreased from（404 ±129） ms before the treatment to（369 ± 105） ms after the treatment; the latency of point C decreased from（2584 ± 563） ms before the treatment to（2308 士 369） ms after the treatment; the amplitude of A-B increased from（10.3 ±17.4）μV before the treatment to（13.7 ±24.8） μV after the treatment, and the differences were statistically significant（all P〈0.05）.Conclusion： Acupuncture can improve the sleep quality and the attention deficit condition of insomnia attention deficit patients by regulating the nerve electrophysiology of the brain.
基金We are thankful to The Gujarat Council on Science and Technology(GUJCOST)for providing financial support in form of minor research project(GUJCOST/MRP/2014-15/2592)
文摘Objective:To explore the effect and mechanism of action of Celastrus paniculatus oil on the treatment of perinatal rats with attention deficit hyperactivity disorder.Methods:In the perinatal stage,the rats were either isolated or administered with lead acetate to establish an animal model of attention deficit hyperactivity disorder.Atomoxetine served as the reference standard.Animals’behaviours were assessed through Y-maze,novel object preference,fear conditioning and residentintruder aggression tests.Oxidative stress parameters,bioamine concentration(dopamine,noradrenaline and 5-hydroxytryptamine),nerve growth factor,interleukin-6,nuclear factor-κB,and tumour necrosis factor(TNF)-αwere estimated.Synaptophysin immunohistochemical assay was performed.Results:Celastrus paniculatus oil significantly improved behavioural parameters in Y maze,novel object preference,discrimination index,fear conditioning and resident intruder aggressive tests.The treatment groups showed a decrease in malondialdehyde level.Changes in the levels of dopamine,noradrenaline,and serotonin were restored by Celastrus paniculatus oil.Celastrus paniculatus oil increased nerve growth factor and decreased interleukin-6,nuclear factor-κB,and TNF-α.Synaptophysin immunoreactivity was also improved by Celastrus paniculatus oil with alleviated reactive gliosis,degeneration,and vascular proliferation.Conclusions:This research shows the therapeutic potential of Celastrus paniculatus oil for the treatment of attention deficit hyperactivity disorder.
基金supported by grants from the National Natural Science Foundation of China (31460263, 30990263, and 31271171)the National Basic Research Development Program (973 Program) of China (2013CB835101)
文摘Attention deficit and hyperactivity disorder （ADHD）, a prevalent syndrome in children worldwide, is characterized by impulsivity, inappropriate inattention, and/or hyperactivity. It seriously afflicts cognitive development in childhood, and may lead to chronic under-achievement, academic failure, problematic peer relationships, and low self-esteem. There are at least three challenges for the treatment of ADHD. First, the neurobiological bases of its symptoms are still not clear. Second, the commonly prescribed medications, most showing short-term therapeutic efficacy but with a high risk of serious side-effects, are mainly based on a dopamine mechanism. Third, more novel and efficient animal models, especially in nonhuman primates, are required to accelerate the development of new medications. In this article, we review research progress in the related fields, focusing on our previous studies showing that blockade of prefrontal cortical a2A-adrenoceptors in monkeys produces almost all the typical behavioral symptoms of ADHD.
文摘BACKGROUND Iron plays an important role in neurodevelopmental functions in the brain.Serum ferritin levels are different in children with attention deficit hyperactivity disorder and tic disorder than in healthy children.AIM To explore the current status of iron deficiency in children with neurodevelopmental disorders and its sex and age effects.METHODS A total of 1565 children with attention deficit hyperactivity disorder(ADHD),1694 children with tic disorder(TD),93 children with ASD and 1997 healthy control children were included between January 1,2020,and December 31,2021 at Beijing Children's Hospital.We describe the differences in age levels and ferritin levels between different disease groups and their sex differences.The differences between the sexes in each disease were analyzed using the t test.The incidence rate of low serum ferritin was used to describe the differences between different diseases and different age groups.A chi-square test was used to analyze the difference in the incidence of low serum ferritin between the disease group and the control group.Analysis of variance was used for comparisons between subgroups,and regression analysis was used for confounding factor control.RESULTS A total of 1565 ADHD patients aged 5-12 years were included in this study,and the average serum ferritin levels of male and female children were 36.82±20.64μg/L and 35.64±18.56μg/L,respectively.A total of 1694 TD patients aged 5-12 years were included in this study,and the average serum ferritin levels of male and female children were 35.72±20.15μg/L and 34.54±22.12μg/L,respectively.As age increased,the incidence of low serum ferritin in ADHD and TD first decreased and then increased,and 10 years old was the turning point of rising levels.The incidence of ADHD with low serum ferritin was 8.37%,the incidence of TD with low serum ferritin was 11.04%,and the incidence of the healthy control group with low serum ferritin was 8.61%,among which male children with TD accounted for 9.25%and female children with TD accounted for 11.62%.There was a significant difference among the three groups(P<0.05).In addition,there were 93 children with ASD with an average serum ferritin level of 30.99±18.11μg/L and a serum ferritin incidence of 15.05%.CONCLUSION In conclusion,low serum ferritin is not a risk factor for ADHD or TD.The incidence of low serum ferritin levels in children with ADHD and TD between 5 and 12 years old decreases first and then increases with age.
基金Scientific Research Innovation of Guangzhou University of Chinese Medicine, No.K004052
文摘BACKGROUND： The core symptoms of attention deficit, impulsiveness, hyperactivity of attention deficit hyperactivity disorders （ADHD） can concurrently present in spontaneous hypertensive rats. Neuropathological, biochemical and pharmacological studies also support it. Spontaneous hypertensive rats are one kind of best ADHD animal models, which has been accepted at present. Yizhining elixation can reinforce kidney and calm liver, strengthen spleen and nourish heart, benefit intelligence and focus attention, but its therapeutic effect on treatment of ADHD needs to be further investigated. OBJECTIVE： To observe the effect of Yizhining elixation on the persistent active attention deficit and impulsiveness of rats with spontaneous hypertension. DESIGN： Observational and controlled analysis. SETTING： Department of Pediatrics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine. MATERIALS： Thirty-six male rats with spontaneous hypertension, of clean grade, were involved in this experiment. The involved rats were provided by Shanghai SLAC Laboratory Animal Co., Ltd., and they did not undergo any experiments; Yizhining elixation was composed by Guiban, Shenglonggu, Yuanzhi, Shichangpu, Yejiaoteng, Shudi, Dangshen, Yunling, Fuxiaomai, Wueizi. etc. Crude drug, provided by Outpatient Dispensary, Affiliated Hospital of Guangzhou University of Chinese Medicine, was prepared into water elixation, which contained crude drug of 1.154 g/mL. METHODS： This experiment was carried out in the Department of Pediatrics, First Affiliated Hospital of Guangzhou University of Chinese Medicine between March and July 2005. The involved rats were randomized into 3 groups： Yizhining high dose group, Yizhining low dose group and blank control group, with 12 rats in each. Changes in sustained attention and impulsiveness of rats were detected before and after administration of Yizhining elixation by ＂5-choice serial response time task＂ method. Following above-mentioned training and detection, rats in each group were daily drenched with Yizhining elixation once for 14 days successively. Rats in the Yizhining High-dose and low-dose groups we, e drenched with 12.6 mL/kg and 6.3 mL/kg Yizhining elixation （diluted to 25 mL/kg） respectively, and those in the blank control group were drenched with 12.5 mL/kg normal saline. On the 14^th day after administration, the ratios of correct and immature response of rats were re-detected for 3 days successively by formal detection method for later analysis. The sustained attention of rats was evaluated with ratio of correct response： Ratio of correct response=[times of correct response/（times of correct response ＋ times of incorrect response）]; impulsiveness was evaluated with the ratio of immature response： ratio of immature response=[times of immature response/ （times of correct response＋times of incorrect response＋times of omission＋times of immature response） ]. MAIN OUTCOME MEASURES： The effects of different doses of Yizhining elixation on the sustained attention （ratio of correct response） and impulsiveness （ratio of immature response） of spontaneous hypertensive rats. RESULTS： Thirty-six spontaneous hypertensive rats were involved in the final analysis. The ratio of correct response of rats in the Yizhining high dose and low dose groups after administration was （98.9±2.30）% and （96.6±4.00） %, respectively, which was significantly higher than that before administration [ （80.4±11.5 ） %, （839±8.90） %, P 〈 0.01] and that in the blank control group[ （83.3±6.30） %, P 〈 0.01]. The ratio of immature response of rats in the Yizhining high dose and low dose groups after adminisWafion was （5.04 ±1.04 ） %, （7.23 ± 1.22 ） %, respectively, which was lower than that before administration [ （9.85 ±2.50） %, （9.40±1.73 ） %, P 〈 0.05] and that in the blank control group [ （ 9.42 ±1.64） %, P 〈 0.01 ]. CONCLUSION： Yizhining elixation can improve the sustained attention and impulsiveness of spontaneous hypertensive rats.
文摘In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the effectiveness of electroencephalogram (EEG) biofeedback training. Of all the 60 children with ADHD aged more than 6 years, the effective rate of EEG biofeedback training was 91.6 % after 40 sessions of EEG biofeedback training. Before and after treatment by EEG biofeedback training, the overall indexes of IVA were significantly improved among predominately inattentive, hyperactive, and combined subtype of children with ADHD (P<0.001). It was suggested that EEG biofeedback training was an effective and vital treatment on children with ADHD.
基金supported in part by the Institute for Basic Science(to HP)No.IBS-R015-D1
文摘Attention deficit hyperactivity disorder（ADHD） is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantified using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identified as regions with significant group-wise differences. The identified regions were correlated with clinical scores reflecting depression and anxiety and significant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain circuitry might differentially impact male and female ADHD patients.
文摘Inappropriate levels of hyperactivity,impulsivity,and inattention characterize attention deficit hyperactivity disorder,a common childhood-onset neuropsychiatric disorder.The cognitive function and learning ability of children with attention deficit hyperactivity disorder are affected,and these symptoms may persist to adulthood if they are not treated.The diagnosis of attention deficit hyperactivity disorder is only based on symptoms and objective tests for attention deficit hyperactivity disorder are missing.Treatments for attention deficit hyperactivity disorder in children include medications,behavior therapy,counseling,and education services which can relieve many of the symptoms of attention deficit hyperactivity disorder but cannot cure it.There is a need for a molecular biomarker to distinguish attention deficit hyperactivity disorder from healthy subjects and other neurological conditions,which would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of attention deficit hyperactivity disorder.The recent studies reviewed had performed microRNA profiling in whole blood,white blood cells,blood plasma,and blood serum of children with attention deficit hyperactivity disorder.A large number of microRNAs were dysregulated when compared to healthy controls and with some overlap between individual studies.From the studies that had included a validation set of patients and controls,potential candidate biomarkers for attention deficit hyperactivity disorder in children could be miR-140-3p,let-7g-5p,-30e-5p,-223-3p,-142-5p,-486-5p,-151a-3p,-151a-5p,and-126-5p in total white blood cells,and miR-4516,-6090,-4763-3p,-4281,-4466,-101-3p,-130a-3p,-138-5p,-195-5p,and-106b-5p in blood serum.Further studies are warranted with children and adults with attention deficit hyperactivity disorder,and consideration should be given to utilizing rat models of attention deficit hyperactivity disorder.Animal studies could be used to confirm microRNA findings in human patients and to test the effects of targeting specific microRNAs on disease progression and behavior.
文摘Objectives:Compare and relate the performance of schoolchildren with Attention Deficit Hyperactivity Disorder(ADHD)and with good academic performance in the visual-motor perceptual and reading processes.Method:Twenty schoolchildren,of both genders,aged between nine and 11 years old,participated in this study.They were divided into two groups:Group I(GI):comprising 10 students diagnosed with ADHD;and Group II(GII):10 students with good academic performance paired according to gender,age group,and educational level with GI.All students were submitted to the Developmental Test of Visual Perception(DTVP 3)and Reading Processes Assessment Protocol(PROLEC).Results:There was lower performance of GI compared to GII in the subtests of copying,eye-hand coordination,and figure-ground in the standard score of general visual perception and visual-motor integration.GI presented lower performance in all reading processes except for the punctuation marks test.There was a statistically significant difference in the comparison between GI and GII regarding the classification of reading processes.A relationship was identified between the reading and visual perception subtests in the GI students,demonstrating a relationship between the visual perceptual motor skills and the reading processes in the group of students with ADHD.Conclusion:Schoolchildren with ADHD performed less well than their peers with good academic performance in the visual-motor perceptual and reading skills;such that the worse their performance in the visual-motor perceptual processes,the worse their performance in the reading processes.
基金Supported by Ningbo Science and Technology Plan Project Public Welfare Plan(Municipal Level),No:2019C50099Ningbo Medical Key Supporting Discipline Child Health Science,No:2022-F26。
文摘BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.
基金supported by the Institute for Basic Science[grant No.IBS-R015-D1]the National Research Foundation of Korea(grant No.NRF-2016R1A2B4008545)
文摘Attention deficit and hyperactivity disorder（ADHD） is a disorder characterized by behavioral symptoms including hyperactivity/impulsivity among children,adolescents,and adults.These ADHD related symptoms are influenced by the complex interaction of brain networks which were under explored.We explored age-related brain network differences between ADHD patients and typically developing（TD） subjects using resting state f MRI（rs-f MRI） for three age groups of children,adolescents,and adults.We collected rs-f MRI data from 184 individuals（27 ADHD children and 31 TD children;32 ADHD adolescents and 32 TD adolescents;and 31 ADHD adults and 31 TD adults）.The Brainnetome Atlas was used to define nodes in the network analysis.We compared three age groups of ADHD and TD subjects to identify the distinct regions that could explain age-related brain network differences based on degree centrality,a well-known measure of nodal centrality.The left middle temporal gyrus showed significant interaction effects between disease status（i.e.,ADHD or TD） and age（i.e.,child,adolescent,or adult）（P 0.001）.Additional regions were identified at a relaxed threshold（P 0.05）.Many of the identified regions（the left inferior frontal gyrus,the left middle temporal gyrus,and the left insular gyrus） were related to cognitive function.The results of our study suggest that aberrant development in cognitive brain regions might be associated with age-related brain network changes in ADHD patients.These findings contribute to better understand how brain function influences the symptoms of ADHD.
