Hyperkinetic disorders and attention deficit hyperactivity disorders

Current Opinion in Psychiatry

Volumn 10, Issue 4, 1997, Pages 300-305

  Swanson, James M ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ATTENTION DEFICIT DISORDER; BIOCHEMISTRY; CHILD; CHILD BEHAVIOR; COGNITION; CORPUS CALLOSUM; HUMAN; HYPERKINESIA; MEDICAL GENETICS; NEUROANATOMY; NEUROPSYCHOLOGY; NUCLEAR MAGNETIC RESONANCE IMAGING; REVIEW;

EID: 0030872119     PISSN: 09517367     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001504-199707000-00009     Document Type: Review

References (39)

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10. Pennington BF, Ozonoff S: Executive functions and developmental psychopathology. J Child Psychol Psychiatry 1996, 37:51-87. This is an excellent review of deficits in executive functions (based on a history of research in complex areas of developmental psychology) in several disorders (HD/ADHD, conduct disorder, autism, and Tourette syndrome). A scholarly discussion of the 'frontal metaphor', a clear and appealing definition of executive functions, an informative discussion of measurement issues unique to developmental psychopathology, and reviews of the literature (based on meta analysis) on each of the disorders are presented. Conclusions are generated from this exemplary approach about which disorders are characterized by executive function deficits (HD/ADHD and autism, but not conduct disorder without ADHD and Tourette syndrome), and how the manifestation of these deficits differ in these two disorders (deficits in inhibition in HD/ADHD and deficits in cognitive flexibility in autism). The review of the literature on HD/ADHD identified a set of tests that may be useful for assessment of deficits in executive functions (Tower of Hanoi, Matching Familiar Figures, Stroop, Trails B, and a variety of motor inhibition tasks).
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12. Carte ET, Nigg JT, Hinshaw SP: Neuropsychological functioning, motor speed and language processing in boys with and without ADHD. J Abnormal Child Psychol 1996, 24:481-498. This study linked information processing and neuropsychological approaches to design an innovative assessment of ADHD children. A test battery was constructed of tasks with two types of instruction sets (slow-careful and fast-paced), and paired tasks were selected which contrasted automatic and controlled processing. A comparison of performance of 51 ADHD individuals and 31 control subjects revealed greater ADHD-related deficits in performance of controlled than automatic processing tasks. A discriminant analysis identified a battery of easy to administer tests: Denkla's rapid-automatic-naming (of use objects) and time-to-do 20 (with legs and arms), and the Porteus mazes.
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22. Filipek PA, Semrud-Chikeman M, Steingard RJ, Renshaw PF, Kennedy DN, Biederman J: Volumetric MRI analysis comparing attention-deficit hyperactivity disorder and normal controls J Child Neurol 1997, 48:1-13. This study used magnetic resonance imaging-based morphometry to investigate hemispheric and structural volumes in 15 pure (noncomorbid) ADHD individuals and 15 control individuals, with specific predictions about anomalies based on neuropsychological theories of ADHD and the literature on functional and anatomical imaging comparing ADHD and control samples. Regional differences suggest that ADHD is characterized by smaller volume of the anterior-superior hemispheric region implicated the alerting network (right posterior prefrontal cortex, motor association area, including Brodmann's areas 6) and the executive control network (midanterior cingulate, as well as smaller caudate) as predicted by the neuroanatomical network theory of Posner and Raichle. Differences (smaller in ADHD individuals) in white matter volume in bilateral posterior regions (superior parietal, inferior parietal, angular gyri, visual visual association cortices) implicated the orienting network. The anterior differences best characterized a subject of 10 favorable responders to stimulant medications and posterior differences best characterized a subset of five non-favorable responders.
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33. Castellanos FX, Elia J, Kruesi MJP, March WL, Gulotta BA, Potter WZ, Ritchie GF, Hamburger SD, Rapoport JL: Cerebrospinal fluid homovanillic acid predicts behavioral response to stimulants in 45 boys with attention deficit/hyperactivity disorder. Neuropsychopharmacology 1996, 14:125-137. This study investigated levels of cerebrospinal fluid homovanillic acid, MHPG, 5-HIAA in 45 ADHD individuals participating in a double-blind trial of methylphenidate, d-amphetamine, and placebo. Significant correlations were reported (0.32 to 0.50) between measures of response to stimulant medication and baseline HVA levels (a dopamine metabolite, presumed to be related to efficacy of stimulant medications) but not MHPG levels (a NE metabolite). This extended the previous results reported for 25 of these individuals (significant correlation of ratings of hyperactivity with placebo homovanillic acid levels), and the increased power of the large sample confirmed the hypothesis that response to stimulant medication would be related to a measure of central dopamine activity. Individuals with low homovanillic acid levels tended to response less well to stimulant medication than those with high levels. These finding were discussed with respect to these dopamine theories: presynaptic compensation for postsynaptic deficits, overactive intraneuronal metabolism, and autoreceptor downregulation of excessive dopamine neurotransmission.
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35. LaHoste GL, Swanson JM, Wigal SB, Glabe C, Wigal T, King N, Kennedy JL: Dopamine D4 receptor gene polymorphism is associated with attention-deficit disorder. Molecular Psychiatry 1996, 1:121-124. This study investigated a gene for the D4 DA receptor which is preferentially distributed in cortical and limbic regions of the brain (and thus is a logical 'candidate gene' based on the site-of-action approach). The 7-repeat allele of this gene (which has a high degree of functionally relevant variability) occurred significantly more often in a sample of 39 HD/ADHD individuals (0.29) than in a tightly ethnically matched control group (0.12, which matched the expected probability). The 7' genotype (defined by presence of at least 17-repeat allele) was significantly greater in the HD/ADHD sample (about 50%) than in the control sample (about 20%), so this was not a necessary or sufficient condition for ADHD, but these findings suggest that polymorphic variation in the DRD4 gene may be a contributing factor in the expression of symptoms of HD/ADHD.
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