Age-dependent and -independent changes in attention-deficit/hyperactivity disorder (ADHD) during spatial working memory performance.

OBJECTIVES: Attention-deficit/hyperactivity disorder (ADHD) has been associated with spatial working memory as well as frontostriatal core deficits. However, it is still unclear how the link between these frontostriatal deficits and working memory function in ADHD differs in children and adults. This study examined spatial working memory in adults and children with ADHD, focussing on identifying regions demonstrating age-invariant or age-dependent abnormalities. METHODS: We used functional magnetic resonance imaging to examine a group of 26 children and 35 adults to study load manipulated spatial working memory in patients and controls. RESULTS: In comparison to healthy controls, patients demonstrated reduced positive parietal and frontostriatal load effects, i.e., less increase in brain activity from low to high load, despite similar task performance. In addition, younger patients showed negative load effects, i.e., a decrease in brain activity from low to high load, in medial prefrontal regions. Load effect differences between ADHD and controls that differed between age groups were found predominantly in prefrontal regions. Age-invariant load effect differences occurred predominantly in frontostriatal regions. CONCLUSIONS: The age-dependent deviations support the role of prefrontal maturation and compensation in ADHD, while the age-invariant alterations observed in frontostriatal regions provide further evidence that these regions reflect a core pathophysiology in ADHD

Developmental changes in gamma-aminobutyric acid levels in attention-deficit/hyperactivity disorder.

While the neurobiological basis and developmental course of attention-deficit/hyperactivity disorder (ADHD) have not yet been fully established, an imbalance between inhibitory/excitatory neurotransmitters is thought to have an important role in the pathophysiology of ADHD. This study examined the changes in cerebral levels of GABA+, glutamate and glutamine in children and adults with ADHD using edited magnetic resonance spectroscopy. We studied 89 participants (16 children with ADHD, 19 control children, 16 adults with ADHD and 38 control adults) in a subcortical voxel (children and adults) and a frontal voxel (adults only). ADHD adults showed increased GABA+ levels relative to controls (P = 0.048), while ADHD children showed no difference in GABA+ in the subcortical voxel (P > 0.1), resulting in a significant age by disorder interaction (P = 0.026). Co-varying for age in an analysis of covariance model resulted in a nonsignificant age by disorder interaction (P = 0.06). Glutamine levels were increased in children with ADHD (P = 0.041), but there was no significant difference in adults (P > 0.1). Glutamate showed no difference between controls and ADHD patients but demonstrated a strong effect of age across both groups (P < 0.001). In conclusion, patients with ADHD show altered levels of GABA+ in a subcortical voxel which change with development. Further, we found increased glutamine levels in children with ADHD, but this difference normalized in adults. These observed imbalances in neurotransmitter levels are associated with ADHD symptomatology and lend new insight in the developmental trajectory and pathophysiology of ADHD

Developmental changes in gamma-aminobutyric acid levels in attention-deficit/hyperactivity disorder

While the neurobiological basis and developmental course of attention-deficit/hyperactivity disorder (ADHD) have not yet been fully established, an imbalance between inhibitory/excitatory neurotransmitters is thought to have an important role in the pathophysiology of ADHD. This study examined the changes in cerebral levels of GABA+, glutamate and glutamine in children and adults with ADHD using edited magnetic resonance spectroscopy. We studied 89 participants (16 children with ADHD, 19 control children, 16 adults with ADHD and 38 control adults) in a subcortical voxel (children and adults) and a frontal voxel (adults only). ADHD adults showed increased GABA+ levels relative to controls (P=0.048), while ADHD children showed no difference in GABA+ in the subcortical voxel (P>0.1), resulting in a significant age by disorder interaction (P=0.026). Co-varying for age in an analysis of covariance model resulted in a nonsignificant age by disorder interaction (P=0.06). Glutamine levels were increased in children with ADHD (P=0.041), but there was no significant difference in adults (P>0.1). Glutamate showed no difference between controls and ADHD patients but demonstrated a strong effect of age across both groups (P<0.001). In conclusion, patients with ADHD show altered levels of GABA+ in a subcortical voxel which change with development. Further, we found increased glutamine levels in children with ADHD, but this difference normalized in adults. These observed imbalances in neurotransmitter levels are associated with ADHD symptomatology and lend new insight in the developmental trajectory and pathophysiology of ADHD

Prevalence of and associated factors for adult attention deficit hyperactivity disorder in young Swiss men.

OBJECTIVE: The present study aimed to measure the prevalence of adult attention deficit hyperactivity disorder (ADHD) in a large, representative sample of young Swiss men and to assess factors associated with this disorder. METHODS: Our sample consisted of 5656 Swiss men (mean age 20 years) who participated in the Cohort Study on Substance Use Risk Factors (C-SURF). ADHD was assessed with the World Health Organization (WHO) adult ADHD Self Report Screener (ASRS). Logistic regression analyses were conducted to assess the association between ADHD and several socio-demographic, clinical and familial factors. RESULTS: The prevalence of ADHD was 4.0%, being higher in older and French-speaking conscripts. A higher prevalence also was identified among men whose mothers had completed primary or high school/university and those with a family history of alcohol or psychiatric problems. Additionally, adults with ADHD demonstrated impairment in their professional life, as well as considerable mental health impairment. CONCLUSION: Our results demonstrate that ADHD is common among young Swiss men. The impairments in function and mental health we observed highlight the need for further support and interventions to reduce burden in affected individuals. Interventions that incorporate the whole family also seem crucial

Emotional processing in Parkinson's disease and anxiety: an EEG study of visual affective word processing

A general problem in the design of an EEG-BCI system is the poor quality and low robustness of the extracted features, affecting overall performance. However, BCI systems that are applicable in real-time and outside clinical settings require high performance. Therefore, we have to improve the current methods for feature extraction. In this work, we investigated EEG source reconstruction techniques to enhance the extracted features based on a linearly constrained minimum variance (LCMV) beamformer. Beamformers allow for easy incorporation of anatomical data and are applicable in real-time. A 32-channel EEG-BCI system was designed for a two-class motor imagery (MI) paradigm. We optimized a synchronous system for two untrained subjects and investigated two aspects. First, we investigated the effect of using beamformers calculated on the basis of three different head models: a template 3-layered boundary element method (BEM) head model, a 3-layered personalized BEM head model and a personalized 5-layered finite difference method (FDM) head model including white and gray matter, CSF, scalp and skull tissue. Second, we investigated the influence of how the regions of interest, areas of expected MI activity, were constructed. On the one hand, they were chosen around electrodes C3 and C4, as hand MI activity theoretically is expected here. On the other hand, they were constructed based on the actual activated regions identified by an fMRI scan. Subsequently, an asynchronous system was derived for one of the subjects and an optimal balance between speed and accuracy was found. Lastly, a real-time application was made. These systems were evaluated by their accuracy, defined as the percentage of correct left and right classifications. From the real-time application, the information transfer rate (ITR) was also determined. An accuracy of 86.60 ± 4.40% was achieved for subject 1 and 78.71 ± 0.73% for subject 2. This gives an average accuracy of 82.66 ± 2.57%. We found that the use of a personalized FDM model improved the accuracy of the system, on average 24.22% with respect to the template BEM model and on average 5.15% with respect to the personalized BEM model. Including fMRI spatial priors did not improve accuracy. Personal fine- tuning largely resolved the robustness problems arising due to the differences in head geometry and neurophysiology between subjects. A real-time average accuracy of 64.26% was reached and the maximum ITR was 6.71 bits/min. We conclude that beamformers calculated with a personalized FDM model have great potential to ameliorate feature extraction and, as a consequence, to improve the performance of real-time BCI systems