Journal of Clinical and Experimental Neuropsychology, 2010
Autism spectrum disorders (ASD) are associated with impaired attentional set shifting, which may ... more Autism spectrum disorders (ASD) are associated with impaired attentional set shifting, which may reflect enhanced perseverative responding, enhanced learned irrelevance, and/or reduced novelty processing. We assessed the contribution of these potential error sources in ASD adults. A total of 17 ASD and 19 matched comparison individuals first solved a discrimination learning task. Thereafter, the participants faced three types of attentional shift, specifically designed to isolate the effect of the three possible error sources. ASD participants made more errors than comparison individuals in a shift implying a choice between a novel relevant stimulus attribute and a familiar attribute that was previously relevant but now irrelevant. However, they made fewer errors in a shift involving a choice between a novel irrelevant attribute and a familiar, previously irrelevant but now relevant attribute. The results in combination suggest that the performance difference, at least in the present shift task, is caused by reduced novelty processing in ASD participants.
Aims. To evaluate the homogeneity of the elements of the Substance Dependence Syndrome (SDS) as a... more Aims. To evaluate the homogeneity of the elements of the Substance Dependence Syndrome (SDS) as applied to benzodiazepines (BZDs
Heightened attention towards negative information is characteristic of depression. Evidence is em... more Heightened attention towards negative information is characteristic of depression. Evidence is emerging for a negative attentional bias in Autism spectrum disorder (ASD), perhaps driven by the high comorbidity between ASD and depression. We investigated whether ASD is characterised by a negative attentional bias and whether this can be explained by comorbid (sub) clinical depression. Participants (n = 116) with current (CD) or remitted depression (RD) and/or ASD, and 64 controls viewed positively and negatively valenced (non-)social pictures. Groups were compared on three components of visual attention using linear mixed models. Both CD individuals with and without ASD, but not remitted depressed and never-depressed ASD individuals showed a negative bias, suggesting that negative attentional bias might be a depressive state-specific marker for depression in ASD.
Deficits in multiple neuropsychological domains and specific personality profiles have been obser... more Deficits in multiple neuropsychological domains and specific personality profiles have been observed in attention-deficit/hyperactivity disorder (ADHD). In this study we investigated whether personality traits are related to neurocognitive profiles in adults with ADHD. Neuropsychological performance and Five Factor Model (FFM) personality traits were measured in adults with ADHD (n = 133) and healthy controls (n = 132). Three neuropsychological profiles, derived from previous community detection analyses, were investigated for personality trait differences. Irrespective of cognitive profile, participants with ADHD showed significantly higher Neuroticism and lower Extraversion, Agreeableness, and Conscientiousness than healthy controls. Only the FFM personality factor Openness differed significantly between the three profiles. Higher Openness was more common in those with aberrant attention and inhibition than those with increased delay discounting and atypical working memory / verbal fluency. The results suggest that the personality trait Openness, but not any other FFM factor, is linked to neurocognitive profiles in ADHD. ADHD symptoms rather than profiles of cognitive impairment have associations with personality traits.
Attention Deficit Hyperactivity Disorder (ADHD) is characterized by poor cognitive control/attent... more Attention Deficit Hyperactivity Disorder (ADHD) is characterized by poor cognitive control/attention and hypofunctioning of the dorsal anterior cingulate cortex (dACC). In the current study, we investigated for the first time whether real-time fMRI neurofeedback (rt-fMRI) training targeted at increasing activation levels within dACC in adults with ADHD leads to a reduction of clinical symptoms and improved cognitive functioning. An exploratory randomized controlled treatment study with blinding of the participants was conducted. Participants with ADHD (n = 7 in the neurofeedback group, and n = 6 in the control group) attended four weekly MRI training sessions (60-min training time/session), during which they performed a mental calculation task at varying levels of difficulty, in order to learn how to up-regulate dACC activation. Only neurofeedback participants received continuous feedback information on actual brain activation levels within dACC. Before and after the training, ADHD ...
ABSTRACT Individuals with autism spectrum disorders (ASD) have problems understanding emotion in ... more ABSTRACT Individuals with autism spectrum disorders (ASD) have problems understanding emotion in social context. However, little is known about whether persons with ASD have problems in processing emotion encoded in language. One recent ERP study showed that, while emotional words elicited an enhanced late positivity component (LPC) relative to neutral words in controls, this LPC-effect was absent in ASD [1]. This suggests that ASD individuals might not have recognized emotion in language, at least not in single words, assuming the LPC reflects allocation of attentional resources [2]. We investigated the processing of emotional sentences in high-functioning ASD individuals and matched controls. Words in sentential context may be more situationally grounded than words in isolation, which may aid emotion processing in ASD. Affectively pleasant, neutral, and unpleasant words were embedded in 120 non-constraining sentential contexts (John gave his wife a kiss/bag/slap). Word valence was assessed with pretests. Additionally, 120 semantically incongruent and congruent sentences were included for verifying conceptual-semantic processing. The sentences were passively read word-by-word by 21 ASD and 21 typical participants while their EEG was recorded. Catch trials consisting of comprehension questions appeared randomly throughout the experiment. No LPC was predicted if individuals with ASD cannot process emotion encoded in language at all. However, an LPC would arise if they can process emotion when encoded in contextually rich language. Both ASD and control participants showed enhanced LPCs for emotional vs. neutral words. The averaged amplitudes of the LPC-effects were smaller in ASD than in controls, albeit non-significantly so. The scalp distributions of the LPC-effects were more right-lateralized in ASD than in the controls. In addition, combining groups, the LPC-effects for negative vs. neutral words were frontally distributed, whereas the LPC-effects for positive vs. neutral words, centrally distributed. Finally, both groups showed central-parietal N400s for semantically incongruent vs. congruent words in sentences. Thus, ASD's processing of conceptual semantics (N400) is intact. Their processing of emotion in words in context is similar to the controls, but may recruit partially different neural mechanisms (smaller and right-lateralized LPC) compared to the typical populations. 1. Lartseva, A., Dijkstra, T., & Buitelaar, J.K. (INSAR2013). Neural Correlates of Emotion Word Processing in Autism Spectrum Disorders. Poster presented at IMFAR2013, 2-3 May, San Sebastian. 2. Holt, D.J., Lynn, S.K., & Kuperberg, G.R. (2008). Neurophysiological Correlates of Comprehending Emotional Meaning in Context. Journal of Cognitive Neuroscience, 21(11), 2245–2262.
Nederlands Tijdschrift Voor Geneeskunde, Jul 1, 2008
Early infantile autism' as defined by Kanner has grown into a spectrum of autistic disord... more Early infantile autism' as defined by Kanner has grown into a spectrum of autistic disorders. The recognition of Asperger's disorder and of pervasive developmental disorder not otherwise specified (PDD-NOS), has led to increased demand for appropriate diagnostic assessment of autism in adults. The expression ofimpairments in social interaction, communication, imagination and mental flexibility changes during development into adulthood. The diagnostic procedure in adult psychiatry should comprise a collateral developmental interview. Autism spectrum disorders in adults may mimic, or be overshadowed by, other psychiatric disorders. For effective diagnosis, the application of structured interviews, such as the 'Autism diagnostic observation schedule' (ADOS), 'Autism diagnostic interview-revised' (ADI-R) or 'Diagnostic interview for social and communication disorders' (DISCO) is recommended.
The aim of this study was to identify risk factors for benzodiazepine (BZD) dependence, such as s... more The aim of this study was to identify risk factors for benzodiazepine (BZD) dependence, such as sociodemographic variables, characteristics of BZD use, and psychiatric parameters, which to date have been found to relate inconsistently to indicators of BZD dependence such as chronic BZD use and BZD withdrawal symptoms. The Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ), Schedules for Clinical Assessment in Neuropsychiatry (SCAN), and Symptom Checklist-90 (SCL-90) were administered to 599 outpatients using BZDs. Regression analyses were conducted using BZD dependence diagnoses and severity scales as dependent variables. BZD dependence diagnoses were only predicted by being a self-help patient and long BZD elimination half-life (for only the DSM-III-R). The main predictors of BZD dependence severity, as measured by the ICD-10, DSM-III-R scales, and Bendep-SRQ Rasch scales, were in decreasing order: (1) being a self-help patient; (2) higher BZD dose, longer duration of BZD use, younger age; and (3) non-native cultural origin, lower level of education, being in outpatient treatment for alcohol and/or drug dependence, and the interaction of BZD dose with duration of BZD use. We conclude that a limited number of recognizable risk factors appear to predict the severity of BZD dependence. Additional administration of a specific BZD dependence instrument is recommended to confirm suspected BZD dependence and guide further clinical decision-making.
Atomoxetine treatment is associated with improvements in functional outcomes in patients with att... more Atomoxetine treatment is associated with improvements in functional outcomes in patients with attention-deficit/hyperactivity disorder (ADHD), although relationships between improvements in these outcomes and reductions in ADHD symptoms have not been comprehensively investigated in adults. The aim of this study was to assess relationships between functional outcomes and ADHD symptoms (primary objective), and to assess time courses of changes in functional outcomes from baseline to weeks 10 and 24 (secondary objective). We analyzed data pooled from seven Eli Lilly-sponsored placebo-controlled trials of atomoxetine in adults with ADHD that had Conners' Adult ADHD Rating Scales-Investigator Rated: Screening Version (CAARS-Inv:SV) total scores and functional outcome data at baseline and at week 10. Two trials also had these data at week 24. Patients were included in these pooled analyses if they had a CAARS-Inv:SV total score at baseline and at one or more post-baseline visits at weeks 10 or 24, or had post-baseline scores that would allow missing scores at weeks 10 or 24 to be imputed. To address the primary objective, changes in functional outcomes during treatment with atomoxetine versus placebo were assessed using last observation carried forward (LOCF) analysis of covariance (ANCOVA) and mixed-effects model repeated measures (MMRM) analysis, and correlations between score changes in CAARS-Inv:SV total and functional outcomes were assessed using Spearman's rank correlation coefficient (r) at weeks 10 and 24. The secondary objective was addressed using MMRM. At baseline, patients generally had moderately severe or worse ADHD symptoms (based on CAARS-Inv:SV total scores) and impaired functional outcomes (based on Adult ADHD Quality-of-Life [AAQoL], Behavior Rating Inventory of Executive Function-Adult Version [BRIEF-A], Sheehan Disability Scale [SDS], and 36-item Short-Form Health Survey [SF-36] scores). These baseline characteristics were comparable in the atomoxetine and placebo groups. For atomoxetine versus placebo, statistically significant improvements were detected in AAQoL total and subscores at weeks 10 and 24, and in BRIEF-A Self-Report scores at week 10, but not in BRIEF-A Informant Report or SDS scores at week 10 (no BRIEF-A or SDS data were available at week 24), and not in SF-36 at weeks 10 or 24. All functional improvements were gradual. During treatment with atomoxetine, there were moderate correlations between reductions in CAARS-Inv:SV total scores and increases in AAQoL total and subscores at weeks 10 and 24 (r range -0.58 to -0.39; n = 394-545), and also with reductions in BRIEF-A Self-Report at week 10 (r = 0.49; n = 256). With placebo, moderate correlations were also found between reductions in CAARS-Inv:SV total scores and increases in AAQoL total and subscores at weeks 10 and 24 (r range -0.56 to -0.28; n = 321-542), and with reductions in BRIEF-A Self-Report at week 10 (r = 0.49; n = 271). However, correlations between changes in CAARS-Inv:SV and BRIEF-A Informant at week 10 were low for atomoxetine-treated patients (r = 0.25; n = 65), moderate with placebo (r = 0.42; n = 72), and there were low/no correlations between changes in CAARS-Inv:SV and functional outcome rating scales that are not specific to ADHD; that is, for atomoxetine-treated patients, SDS total r = 0.19 (n = 32 at week 10) and SF-36 r range - 0.20 to -0.01 (n = 51 at week 10, n = 183 at week 24). Atomoxetine-treated adult patients experienced improvements in functional outcomes (AAQoL and BRIEF-A Self-Report) that correlated with reductions in ADHD symptoms. Although atomoxetine improved both the ADHD symptoms and functional outcomes, the correlation between symptoms and functional outcomes was low to moderate, suggesting that they measure overlapping but different aspects of the disorder. Hence, clinicians should assess not just ADHD symptoms, but also the functional impairments.
Journal of neural transmission (Vienna, Austria : 1996), Aug 2, 2016
The dopamine transporter gene, DAT1 (SLC6A3), has been studied extensively as a candidate gene fo... more The dopamine transporter gene, DAT1 (SLC6A3), has been studied extensively as a candidate gene for attention-deficit/hyperactivity disorder (ADHD). Different alleles of variable number of tandem repeats (VNTRs) in this gene have been associated with childhood ADHD (10/10 genotype and haplotype 10-6) and adult ADHD (haplotype 9-6). This suggests a differential association depending on age, and a role of DAT1 in modulating the ADHD phenotype over the lifespan. The DAT1 gene may mediate susceptibility to ADHD through effects on striatal volumes, where it is most highly expressed. In an attempt to clarify its mode of action, we examined the effect of three DAT1 alleles (10/10 genotype, and the haplotypes 10-6 and 9-6) on bilateral striatal volumes (nucleus accumbens, caudate nucleus, and putamen) derived from structural magnetic resonance imaging scans using automated tissue segmentation. Analyses were performed separately in three cohorts with cross-sectional MRI data, a childhood/adol...
... ADHD 9 Ronald C. Kessler, Leonard A. Adler, Russell Barkley, Joseph Biederman, C. Keith Conne... more ... ADHD 9 Ronald C. Kessler, Leonard A. Adler, Russell Barkley, Joseph Biederman, C. Keith Conners, Laurence L. Greenhill, and Thomas ... Contents 16 ADHD, personality, and its disorders 174 Fiona E. van Dijk and Henrik Anckarsäter Section 5Pharmacological treatment of ...
Journal of Clinical and Experimental Neuropsychology, 2010
Autism spectrum disorders (ASD) are associated with impaired attentional set shifting, which may ... more Autism spectrum disorders (ASD) are associated with impaired attentional set shifting, which may reflect enhanced perseverative responding, enhanced learned irrelevance, and/or reduced novelty processing. We assessed the contribution of these potential error sources in ASD adults. A total of 17 ASD and 19 matched comparison individuals first solved a discrimination learning task. Thereafter, the participants faced three types of attentional shift, specifically designed to isolate the effect of the three possible error sources. ASD participants made more errors than comparison individuals in a shift implying a choice between a novel relevant stimulus attribute and a familiar attribute that was previously relevant but now irrelevant. However, they made fewer errors in a shift involving a choice between a novel irrelevant attribute and a familiar, previously irrelevant but now relevant attribute. The results in combination suggest that the performance difference, at least in the present shift task, is caused by reduced novelty processing in ASD participants.
Aims. To evaluate the homogeneity of the elements of the Substance Dependence Syndrome (SDS) as a... more Aims. To evaluate the homogeneity of the elements of the Substance Dependence Syndrome (SDS) as applied to benzodiazepines (BZDs
Heightened attention towards negative information is characteristic of depression. Evidence is em... more Heightened attention towards negative information is characteristic of depression. Evidence is emerging for a negative attentional bias in Autism spectrum disorder (ASD), perhaps driven by the high comorbidity between ASD and depression. We investigated whether ASD is characterised by a negative attentional bias and whether this can be explained by comorbid (sub) clinical depression. Participants (n = 116) with current (CD) or remitted depression (RD) and/or ASD, and 64 controls viewed positively and negatively valenced (non-)social pictures. Groups were compared on three components of visual attention using linear mixed models. Both CD individuals with and without ASD, but not remitted depressed and never-depressed ASD individuals showed a negative bias, suggesting that negative attentional bias might be a depressive state-specific marker for depression in ASD.
Deficits in multiple neuropsychological domains and specific personality profiles have been obser... more Deficits in multiple neuropsychological domains and specific personality profiles have been observed in attention-deficit/hyperactivity disorder (ADHD). In this study we investigated whether personality traits are related to neurocognitive profiles in adults with ADHD. Neuropsychological performance and Five Factor Model (FFM) personality traits were measured in adults with ADHD (n = 133) and healthy controls (n = 132). Three neuropsychological profiles, derived from previous community detection analyses, were investigated for personality trait differences. Irrespective of cognitive profile, participants with ADHD showed significantly higher Neuroticism and lower Extraversion, Agreeableness, and Conscientiousness than healthy controls. Only the FFM personality factor Openness differed significantly between the three profiles. Higher Openness was more common in those with aberrant attention and inhibition than those with increased delay discounting and atypical working memory / verbal fluency. The results suggest that the personality trait Openness, but not any other FFM factor, is linked to neurocognitive profiles in ADHD. ADHD symptoms rather than profiles of cognitive impairment have associations with personality traits.
Attention Deficit Hyperactivity Disorder (ADHD) is characterized by poor cognitive control/attent... more Attention Deficit Hyperactivity Disorder (ADHD) is characterized by poor cognitive control/attention and hypofunctioning of the dorsal anterior cingulate cortex (dACC). In the current study, we investigated for the first time whether real-time fMRI neurofeedback (rt-fMRI) training targeted at increasing activation levels within dACC in adults with ADHD leads to a reduction of clinical symptoms and improved cognitive functioning. An exploratory randomized controlled treatment study with blinding of the participants was conducted. Participants with ADHD (n = 7 in the neurofeedback group, and n = 6 in the control group) attended four weekly MRI training sessions (60-min training time/session), during which they performed a mental calculation task at varying levels of difficulty, in order to learn how to up-regulate dACC activation. Only neurofeedback participants received continuous feedback information on actual brain activation levels within dACC. Before and after the training, ADHD ...
ABSTRACT Individuals with autism spectrum disorders (ASD) have problems understanding emotion in ... more ABSTRACT Individuals with autism spectrum disorders (ASD) have problems understanding emotion in social context. However, little is known about whether persons with ASD have problems in processing emotion encoded in language. One recent ERP study showed that, while emotional words elicited an enhanced late positivity component (LPC) relative to neutral words in controls, this LPC-effect was absent in ASD [1]. This suggests that ASD individuals might not have recognized emotion in language, at least not in single words, assuming the LPC reflects allocation of attentional resources [2]. We investigated the processing of emotional sentences in high-functioning ASD individuals and matched controls. Words in sentential context may be more situationally grounded than words in isolation, which may aid emotion processing in ASD. Affectively pleasant, neutral, and unpleasant words were embedded in 120 non-constraining sentential contexts (John gave his wife a kiss/bag/slap). Word valence was assessed with pretests. Additionally, 120 semantically incongruent and congruent sentences were included for verifying conceptual-semantic processing. The sentences were passively read word-by-word by 21 ASD and 21 typical participants while their EEG was recorded. Catch trials consisting of comprehension questions appeared randomly throughout the experiment. No LPC was predicted if individuals with ASD cannot process emotion encoded in language at all. However, an LPC would arise if they can process emotion when encoded in contextually rich language. Both ASD and control participants showed enhanced LPCs for emotional vs. neutral words. The averaged amplitudes of the LPC-effects were smaller in ASD than in controls, albeit non-significantly so. The scalp distributions of the LPC-effects were more right-lateralized in ASD than in the controls. In addition, combining groups, the LPC-effects for negative vs. neutral words were frontally distributed, whereas the LPC-effects for positive vs. neutral words, centrally distributed. Finally, both groups showed central-parietal N400s for semantically incongruent vs. congruent words in sentences. Thus, ASD's processing of conceptual semantics (N400) is intact. Their processing of emotion in words in context is similar to the controls, but may recruit partially different neural mechanisms (smaller and right-lateralized LPC) compared to the typical populations. 1. Lartseva, A., Dijkstra, T., & Buitelaar, J.K. (INSAR2013). Neural Correlates of Emotion Word Processing in Autism Spectrum Disorders. Poster presented at IMFAR2013, 2-3 May, San Sebastian. 2. Holt, D.J., Lynn, S.K., & Kuperberg, G.R. (2008). Neurophysiological Correlates of Comprehending Emotional Meaning in Context. Journal of Cognitive Neuroscience, 21(11), 2245–2262.
Nederlands Tijdschrift Voor Geneeskunde, Jul 1, 2008
Early infantile autism' as defined by Kanner has grown into a spectrum of autistic disord... more Early infantile autism' as defined by Kanner has grown into a spectrum of autistic disorders. The recognition of Asperger's disorder and of pervasive developmental disorder not otherwise specified (PDD-NOS), has led to increased demand for appropriate diagnostic assessment of autism in adults. The expression ofimpairments in social interaction, communication, imagination and mental flexibility changes during development into adulthood. The diagnostic procedure in adult psychiatry should comprise a collateral developmental interview. Autism spectrum disorders in adults may mimic, or be overshadowed by, other psychiatric disorders. For effective diagnosis, the application of structured interviews, such as the 'Autism diagnostic observation schedule' (ADOS), 'Autism diagnostic interview-revised' (ADI-R) or 'Diagnostic interview for social and communication disorders' (DISCO) is recommended.
The aim of this study was to identify risk factors for benzodiazepine (BZD) dependence, such as s... more The aim of this study was to identify risk factors for benzodiazepine (BZD) dependence, such as sociodemographic variables, characteristics of BZD use, and psychiatric parameters, which to date have been found to relate inconsistently to indicators of BZD dependence such as chronic BZD use and BZD withdrawal symptoms. The Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ), Schedules for Clinical Assessment in Neuropsychiatry (SCAN), and Symptom Checklist-90 (SCL-90) were administered to 599 outpatients using BZDs. Regression analyses were conducted using BZD dependence diagnoses and severity scales as dependent variables. BZD dependence diagnoses were only predicted by being a self-help patient and long BZD elimination half-life (for only the DSM-III-R). The main predictors of BZD dependence severity, as measured by the ICD-10, DSM-III-R scales, and Bendep-SRQ Rasch scales, were in decreasing order: (1) being a self-help patient; (2) higher BZD dose, longer duration of BZD use, younger age; and (3) non-native cultural origin, lower level of education, being in outpatient treatment for alcohol and/or drug dependence, and the interaction of BZD dose with duration of BZD use. We conclude that a limited number of recognizable risk factors appear to predict the severity of BZD dependence. Additional administration of a specific BZD dependence instrument is recommended to confirm suspected BZD dependence and guide further clinical decision-making.
Atomoxetine treatment is associated with improvements in functional outcomes in patients with att... more Atomoxetine treatment is associated with improvements in functional outcomes in patients with attention-deficit/hyperactivity disorder (ADHD), although relationships between improvements in these outcomes and reductions in ADHD symptoms have not been comprehensively investigated in adults. The aim of this study was to assess relationships between functional outcomes and ADHD symptoms (primary objective), and to assess time courses of changes in functional outcomes from baseline to weeks 10 and 24 (secondary objective). We analyzed data pooled from seven Eli Lilly-sponsored placebo-controlled trials of atomoxetine in adults with ADHD that had Conners' Adult ADHD Rating Scales-Investigator Rated: Screening Version (CAARS-Inv:SV) total scores and functional outcome data at baseline and at week 10. Two trials also had these data at week 24. Patients were included in these pooled analyses if they had a CAARS-Inv:SV total score at baseline and at one or more post-baseline visits at weeks 10 or 24, or had post-baseline scores that would allow missing scores at weeks 10 or 24 to be imputed. To address the primary objective, changes in functional outcomes during treatment with atomoxetine versus placebo were assessed using last observation carried forward (LOCF) analysis of covariance (ANCOVA) and mixed-effects model repeated measures (MMRM) analysis, and correlations between score changes in CAARS-Inv:SV total and functional outcomes were assessed using Spearman's rank correlation coefficient (r) at weeks 10 and 24. The secondary objective was addressed using MMRM. At baseline, patients generally had moderately severe or worse ADHD symptoms (based on CAARS-Inv:SV total scores) and impaired functional outcomes (based on Adult ADHD Quality-of-Life [AAQoL], Behavior Rating Inventory of Executive Function-Adult Version [BRIEF-A], Sheehan Disability Scale [SDS], and 36-item Short-Form Health Survey [SF-36] scores). These baseline characteristics were comparable in the atomoxetine and placebo groups. For atomoxetine versus placebo, statistically significant improvements were detected in AAQoL total and subscores at weeks 10 and 24, and in BRIEF-A Self-Report scores at week 10, but not in BRIEF-A Informant Report or SDS scores at week 10 (no BRIEF-A or SDS data were available at week 24), and not in SF-36 at weeks 10 or 24. All functional improvements were gradual. During treatment with atomoxetine, there were moderate correlations between reductions in CAARS-Inv:SV total scores and increases in AAQoL total and subscores at weeks 10 and 24 (r range -0.58 to -0.39; n = 394-545), and also with reductions in BRIEF-A Self-Report at week 10 (r = 0.49; n = 256). With placebo, moderate correlations were also found between reductions in CAARS-Inv:SV total scores and increases in AAQoL total and subscores at weeks 10 and 24 (r range -0.56 to -0.28; n = 321-542), and with reductions in BRIEF-A Self-Report at week 10 (r = 0.49; n = 271). However, correlations between changes in CAARS-Inv:SV and BRIEF-A Informant at week 10 were low for atomoxetine-treated patients (r = 0.25; n = 65), moderate with placebo (r = 0.42; n = 72), and there were low/no correlations between changes in CAARS-Inv:SV and functional outcome rating scales that are not specific to ADHD; that is, for atomoxetine-treated patients, SDS total r = 0.19 (n = 32 at week 10) and SF-36 r range - 0.20 to -0.01 (n = 51 at week 10, n = 183 at week 24). Atomoxetine-treated adult patients experienced improvements in functional outcomes (AAQoL and BRIEF-A Self-Report) that correlated with reductions in ADHD symptoms. Although atomoxetine improved both the ADHD symptoms and functional outcomes, the correlation between symptoms and functional outcomes was low to moderate, suggesting that they measure overlapping but different aspects of the disorder. Hence, clinicians should assess not just ADHD symptoms, but also the functional impairments.
Journal of neural transmission (Vienna, Austria : 1996), Aug 2, 2016
The dopamine transporter gene, DAT1 (SLC6A3), has been studied extensively as a candidate gene fo... more The dopamine transporter gene, DAT1 (SLC6A3), has been studied extensively as a candidate gene for attention-deficit/hyperactivity disorder (ADHD). Different alleles of variable number of tandem repeats (VNTRs) in this gene have been associated with childhood ADHD (10/10 genotype and haplotype 10-6) and adult ADHD (haplotype 9-6). This suggests a differential association depending on age, and a role of DAT1 in modulating the ADHD phenotype over the lifespan. The DAT1 gene may mediate susceptibility to ADHD through effects on striatal volumes, where it is most highly expressed. In an attempt to clarify its mode of action, we examined the effect of three DAT1 alleles (10/10 genotype, and the haplotypes 10-6 and 9-6) on bilateral striatal volumes (nucleus accumbens, caudate nucleus, and putamen) derived from structural magnetic resonance imaging scans using automated tissue segmentation. Analyses were performed separately in three cohorts with cross-sectional MRI data, a childhood/adol...
... ADHD 9 Ronald C. Kessler, Leonard A. Adler, Russell Barkley, Joseph Biederman, C. Keith Conne... more ... ADHD 9 Ronald C. Kessler, Leonard A. Adler, Russell Barkley, Joseph Biederman, C. Keith Conners, Laurence L. Greenhill, and Thomas ... Contents 16 ADHD, personality, and its disorders 174 Fiona E. van Dijk and Henrik Anckarsäter Section 5Pharmacological treatment of ...
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