Advances in ADHD—Second Edition

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Developmental Neuroscience".

Deadline for manuscript submissions: closed (31 October 2024) | Viewed by 17577

Special Issue Editor


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Guest Editor
Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
Interests: ADHD; psychopharmacology; epidemiology; psychosocial treatment
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Special Issue Information

Dear Colleagues,

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children, with an estimated worldwide prevalence of around 5%, and when applying empirically supported methods of diagnosis, the disorder persists into young adulthood for many people. The male-to-female ratio is around 3:1 in children and adolescents, but it is believed that females are under-diagnosed.

The etiology of ADHD involves the interplay of multiple genetic and environmental factors. There is no one direct cause for ADHD, either genetic or non-genetic. Rather, it is the complex interactions of multiple genes and multiple environmental risk factors. ADHD is a chronic disorder with identified genetic underpinnings, neurochemical and structural brain abnormalities, and common symptom presentations.

ADHD-related dysfunction includes occupational, academic, family, social, emotional and interpersonal functional impairments.

There is a need for a clear and concise approach to a complex disorder such as ADHD. Understanding the diagnosis and management of ADHD is incomplete without understanding comorbidities and how to manage them.

This Special Issue will provide insight into the important advances in the diagnosis and management of ADHD and its comorbid disorders. The Special Issue will also highlight recent advances in the neurobiology of ADHD.

Prof. Dr. Joseph Sadek
Guest Editor

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Keywords

  • attention-deficit/hyperactivity disorder (ADHD)
  • diagnosis
  • management
  • neurobiology
  • etiology
  • neuropsychology
  • cognition
  • comorbidities
  • treatment response

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Published Papers (6 papers)

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Research

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16 pages, 2867 KiB  
Article
Eye Tracking-Based Characterization of Fixations during Reading in Children with Neurodevelopmental Disorders
by Carmen Bilbao, Alba Carrera, Sofia Otin and David P. Piñero
Brain Sci. 2024, 14(8), 750; https://doi.org/10.3390/brainsci14080750 - 26 Jul 2024
Cited by 1 | Viewed by 1459
Abstract
An efficient mode of evaluation for eye movements is the use of objective eye tracking systems combined with subjective tests (NSUCO or DEM), which are easily applicable across all age groups and in eye care clinical settings. The objective of this study was [...] Read more.
An efficient mode of evaluation for eye movements is the use of objective eye tracking systems combined with subjective tests (NSUCO or DEM), which are easily applicable across all age groups and in eye care clinical settings. The objective of this study was to characterize fixations during reading in two groups: a group of children with neurodevelopmental disorders (NDDG, 24 children, age: 6–12 years) and a group of children with oculomotor anomalies but without NDD (OAG, 24 children, age: 6–12 years). The results obtained were compared with those from a control group (CG, 20 children, age: 6–12 years). Specifically, the outcomes obtained with two subjective score systems, the Northeastern State University College of Optometry’s Oculomotor (NSUCO) test and the Developmental Eye Movement (DEM) test, were compared with the objective analysis obtained through a commercially available eye tracker (Tobii Eye X, Tobii, Stockholm, Sweden). Specialized analysis software, namely Clinical Eye Tracker 2020 (Thomson Software Solutions, Welham Green, UK), was used. It was found that children with NDD had impaired oculomotor skills. A higher number of regressions, more fixations, and longer durations of fixations appear to be characteristic signs of this population group. Additionally, children with NDD took longer to complete the DEM test, as well as exhibiting more errors. The use of objective videoculographic systems for eye tracking and subjective tests like the NSUCO or DEM are good tools to assess saccadic movements, allowing the detection of oculomotor abnormalities in children with NDD. Full article
(This article belongs to the Special Issue Advances in ADHD—Second Edition)
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17 pages, 1907 KiB  
Article
Hyperactivity in ADHD: Friend or Foe?
by Beverly-Ann Hoy, Michelle Bi, Matthew Lam, Gayuni Krishnasamy, Androu Abdalmalak and Barbara Fenesi
Brain Sci. 2024, 14(7), 719; https://doi.org/10.3390/brainsci14070719 - 17 Jul 2024
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Abstract
Background: Hyperactivity may play a functional role in upregulating prefrontal cortical hypoarousal and executive functioning in ADHD. This study investigated the neurocognitive impact of movement during executive functioning on children with ADHD. Methods: Twenty-four children with and without ADHD completed a Stroop task [...] Read more.
Background: Hyperactivity may play a functional role in upregulating prefrontal cortical hypoarousal and executive functioning in ADHD. This study investigated the neurocognitive impact of movement during executive functioning on children with ADHD. Methods: Twenty-four children with and without ADHD completed a Stroop task and self-efficacy ratings while remaining stationary (Stationary condition) and while desk cycling (Movement condition). Simultaneous functional near-infrared spectroscopy (fNIRS) recorded oxygenated and deoxygenated changes in hemoglobin within the left dorsolateral prefrontal cortex (DLPFC). Results: Among children with ADHD, the Movement condition produced superior Stroop reaction time compared to the Stationary condition (p = 0.046, d = 1.00). Self-efficacy improved in the Movement condition (p = 0.033, d = 0.41), whereas it did not in the Stationary condition (p = 0.323). Seventy-eight percent of participants showed greater oxygenation in the left DLPFC during the Movement condition vs. the Stationary condition. Among children without ADHD, there were no differences in Stroop or self-efficacy outcomes between Stationary and Movement conditions (ps > 0.085, ts < 1.45); 60% of participants showed greater oxygenation in the left DLPFC during the Movement vs. the Stationary condition. Conclusions: This work provides supportive evidence that hyperactivity in ADHD may be a compensatory mechanism to upregulate PFC hypoarousal to support executive functioning and self-efficacy. Full article
(This article belongs to the Special Issue Advances in ADHD—Second Edition)
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15 pages, 303 KiB  
Article
An Open-Label Study of a Wearable Device Targeting ADHD, Executive Function, and Academic Performance
by Lindsay E. Ayearst, Richard Brancaccio and Margaret Danielle Weiss
Brain Sci. 2023, 13(12), 1728; https://doi.org/10.3390/brainsci13121728 - 18 Dec 2023
Cited by 3 | Viewed by 3755
Abstract
Objective: This was an open-label pilot study to test the feasibility and preliminary efficacy of a wearable digital intervention developed to improve on-task behavior. This was an exploratory study to test for specificity of response on parent- and teacher-reported symptom outcomes in attention [...] Read more.
Objective: This was an open-label pilot study to test the feasibility and preliminary efficacy of a wearable digital intervention developed to improve on-task behavior. This was an exploratory study to test for specificity of response on parent- and teacher-reported symptom outcomes in attention and hyperactive/impulsive symptoms, as well as domains of functional impairment, including school behavior and learning and executive function. Method:Participants included 38 children aged 8–12 years with a parent-reported past diagnosis of ADHD. Following baseline ratings from parents (N = 38) and teachers (N = 26), participants wore the device to school for four weeks. Parent and teacher ratings of ADHD symptoms, executive function, and functional impairment were repeated at the end of the four-week intervention period. Results:Statistically significant improvement was seen in the total scores for all parent and nearly all teacher outcomes, with moderate effect size improvements in attention, organization and planning, self-monitoring, school functioning, and teacher-reported academic performance. Conclusions: Preliminary evidence from this open-label pilot study suggests that having a child interact with a wearable device to self-monitor attention is feasible. This exploratory, open-label pilot study found real-world improvement in functional domains, including academic performance. Future research will require a blinded, randomized, controlled trial using an appropriate sham comparator to confirm these findings. Full article
(This article belongs to the Special Issue Advances in ADHD—Second Edition)

Review

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11 pages, 637 KiB  
Review
A Narrative Review Exploring Attention Deficit/Hyperactivity Disorder in Patients with Early Psychosis
by Temi Toba-Oluboka and Kara Dempster
Brain Sci. 2024, 14(3), 190; https://doi.org/10.3390/brainsci14030190 - 20 Feb 2024
Cited by 2 | Viewed by 1814
Abstract
While both Attention deficit hyperactivity disorder (ADHD) and schizophrenia are considered to have neurodevelopmental origins with associated impairments in executive functioning, there is a paucity of clinical guidelines pertaining specifically to this comorbidity. We sought to summarize the existing literature on ADHD in [...] Read more.
While both Attention deficit hyperactivity disorder (ADHD) and schizophrenia are considered to have neurodevelopmental origins with associated impairments in executive functioning, there is a paucity of clinical guidelines pertaining specifically to this comorbidity. We sought to summarize the existing literature on ADHD in early psychosis patients, focusing on issues that would be most relevant to clinical practice. For this narrative review, we completed a search on PubMed and PsycINFO with 22 papers meeting criteria for review. Overall, it appears that a diagnosis of ADHD in childhood increases the risk of the subsequent development of a primary psychotic disorder. This risk may be modified by higher rates of substance use and could be related to shared premorbid risk factors for both conditions, such as obstetrical complications. Stimulant use has been associated with the onset of psychotic symptoms in some individuals, but it is unclear whether certain subgroups are more susceptible. Despite the fact that these two conditions co-occur relatively frequently, there is currently a lack of objective diagnostic tests for ADHD specific to populations with primary psychotic disorders, and a paucity of evidence on whether stimulants are effective for ADHD symptoms in this sub-group. Future research is warranted to investigate whether stimulant treatment confers any additional risks for symptom exacerbation in individuals with primary psychotic disorders taking antipsychotic maintenance treatment. Full article
(This article belongs to the Special Issue Advances in ADHD—Second Edition)
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Other

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22 pages, 3453 KiB  
Systematic Review
Noninvasive Brain Stimulation for Improving Cognitive Deficits and Clinical Symptoms in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis
by Yao Yin, Xueke Wang and Tingyong Feng
Brain Sci. 2024, 14(12), 1237; https://doi.org/10.3390/brainsci14121237 - 9 Dec 2024
Viewed by 365
Abstract
Objective: Noninvasive brain stimulation (NIBS) is a promising complementary treatment for attention-deficit/hyperactivity disorder (ADHD). However, its efficacy varies due to diverse participant profiles and methodologies. This meta-analysis, registered with PROSPERO (CRD42023457269), seeks to assess NIBS efficacy in improving cognitive deficits and clinical [...] Read more.
Objective: Noninvasive brain stimulation (NIBS) is a promising complementary treatment for attention-deficit/hyperactivity disorder (ADHD). However, its efficacy varies due to diverse participant profiles and methodologies. This meta-analysis, registered with PROSPERO (CRD42023457269), seeks to assess NIBS efficacy in improving cognitive deficits and clinical symptoms in individuals with ADHD. Methods: We systematically searched five databases (October 2024) for randomized controlled trials focusing on cognitive functions and clinical symptoms in individuals meeting the DSM/ICD criteria for ADHD. A meta-analytical synthesis was conducted using RevMan 5.4.1. Results: Meta-analyses found significant improvement in inhibitory control, working memory, and inattention in active transcranial direct current stimulation (tDCS) groups compared with sham groups. Conversely, repetitive transcranial magnetic stimulation (rTMS) did not demonstrate significant therapeutic benefits for ADHD symptoms. Additionally, four transcranial random noise stimulation (tRNS) and three transcranial alternating current stimulation (tACS) studies demonstrated promising improvements in executive functions and the alleviation of ADHD symptoms. Conclusions: The findings from this meta-analysis highlight NIBS as a promising adjunctive therapy for managing ADHD, advancing both theoretical knowledge and practical treatment options in this field. Full article
(This article belongs to the Special Issue Advances in ADHD—Second Edition)
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9 pages, 264 KiB  
Opinion
Attention Deficit Hyperactivity Disorder Misdiagnosis: Why Medical Evaluation Should Be a Part of ADHD Assessment
by Joseph Sadek
Brain Sci. 2023, 13(11), 1522; https://doi.org/10.3390/brainsci13111522 - 28 Oct 2023
Cited by 2 | Viewed by 7030
Abstract
Introduction: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that interferes with multiple aspects of daily functioning and is associated with impairments in several domains. It may affect academic, educational, vocational, social, emotional, interpersonal, and health domains, and worsen risks to health [...] Read more.
Introduction: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that interferes with multiple aspects of daily functioning and is associated with impairments in several domains. It may affect academic, educational, vocational, social, emotional, interpersonal, and health domains, and worsen risks to health outcomes. Objective: To identify and discuss medical conditions that commonly present with symptoms resembling ADHD. Method: This review is selective and not systematic. It is conducted through a focused literature search through PubMed, Google Scholar, and EMBASE. Search term included “ADHD misdiagnosis”, “medical conditions with ADHD like symptoms”, “ADHD AND medical problems”. Exclusion: giftedness, high IQ, and any article that does not list medical conditions. The limits applied were the following: the work must have been published in the past 20 years, be on humans, and be in the English language. Results: There are several medical conditions that can be misdiagnosed as ADHD and may show a similar presentation to ADHD, particularly with inattentive symptoms. Examples include, but are not limited to, absence seizure disorder, diabetes, thyroid dysfunction, sleep deprivation, post-concussion states, inflammatory bowel disease, iron deficiency states and anemia, and disordered breathing. Conclusions: Our review suggests that a thorough medical evaluation should be conducted prior to the diagnosis of ADHD. Allied health professionals and psychologists who diagnose ADHD should seek medical clearance from a physician prior to making the ADHD diagnosis in order to reduce misdiagnosis rates and improve patient outcomes. ADHD diagnosis should follow guidelines and be carried out under a systematic standardized approach. A full medical evaluation should be conducted to assess for medical conditions that may look like ADHD or be associated with ADHD. Full article
(This article belongs to the Special Issue Advances in ADHD—Second Edition)
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