Theories concerning the etiology of attention deficit hyperactivity disorder have evolved from the 1950s, when it was believed that an injury to or dysfunction of the diencephalon was the cause of the syndrome, to the present day, when delayed brain maturation is postulated as an explanation. Delay in laying down myelin can be investigated by newly developed techniques like computerized EEG and transcranial magnetic stimulation. In this study, a group of 15 children 3-7 years of age suffering from attention deficit were investigated using both methods in combination and were compared to a control group of 23 age-matched normal children. On the computerized EEG spectral analysis significant differences to the control group were found in areas O1 and O2 (P < 0.05, Student's t-test). With transcranial magnetic stimulation, the overall difference in right/left stimulation was statistically significant (P < 0.001). The results suggest delayed myelination at the brain stem reticular formation where the alpha rhythm is activated and at the corticospinal pathway as parts of a widespread involvement.

Twenty-seven children and adolescents aged 4 to 18 years, fulfilling the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for attention-deficit hyperactivity disorder, were included in this study. The diagnosis was determined by a pediatric neurologist and a psychologist examined all 27 subjects with tests that included the Wechsler Intelligence Scale for Children-Revised (WISC-R) and reading, writing, handedness, personality, and anxiety scores. Subjects with histories of epilepsy, head injury, drug abuse, or psychotic disorders were excluded. Culturally based causes or emotional disorders were also excluded. Transcranial magnetic stimulation was performed on all subjects, with recording of the motor evoked potential at the biceps brachii. Central motor conduction time was calculated by cervical root stimulation. Due to shape variability, the amplitude of the motor responses was not measured in the study. The mean value of central conduction time in the subjects was very significantly increased (P < .001) compared to that in a group of normal controls, case-matched for IQ, age, and sex. A central motor conduction time greater than 12 ms indicates abnormality. A second finding in the subjects was the significant difference of central conduction time on the side-to-side stimulation (P = .03). These findings are correlated with delay in the maturation of the corticomotoneuronal system and might provide neurophysiologic data for diagnosis.

Use of different effectors in two consecutive actions could generate an attentional shift between the effectors with shorter latencies in the second action of reaching. 18 participants (10 men; M age = 21.3 yr.) participated in an experiment with two main variables: (1) effector switching with two levels (Switching and No Switching), where the participants use or do not use a different motor effector for each action; (2) lifting muscles, i.e., the muscles involved in the first phase of the reaching, with two levels (finger-lifting muscle and palm-lifting muscle). Premotor time, Motor time, Reaction time, Movement time, and Total time were measured. For Premotor, Movement, and Total times, faster responses were observed when there was no switching of the effector. This delay could be due to an attentional shift between motor effectors and its relations with motor processes. Possible applications include the ergonomic design of device controls, considering that the use of the same effector is beneficial when fast reaction times are sought.