Age-related differences in frontal lobe function in children with ADHD

Yasumura, Akira; Omori, Mikimasa; Fukuda, Ayako; Takahashi, Jutaro; Yasumura, Yukiko; Nakagawa, Eiji; Koike, Takao; Yamashita, Yushiro; Miyajima, Tasuku; Koeda, Tatsuya; Aihara, Masao; Inagaki, Masumi

doi:10.1016/j.braindev.2019.03.006

Cited by 43 publications

(46 citation statements)

References 27 publications

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“…Therefore, EFs are mediated by the prefrontal cortex and demand a higher and more complex cognitive-behavioral requirement than is commonly needed to perform goal-orientated behavior. One of the main problems that ADHD subjects present is the difficulty in inhibitory control and the organization of tasks that require a set of consecutive steps (Yasumura et al, 2019), which leads to them showing deficiencies in EFs, the cognitive aptitude that the ENFEN battery requires, in a greater or lesser extent, in each subtest (Portellano et al, 2009). This instrument allows to evaluate EFs and has been widely used in clinical and school contexts, allowing the detection of possible maturational delays or cognitive alterations derived from brain damage or dysfunction, especially in prefrontal areas (Portellano, 2014;Navarro et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Detection of Executive Performance Profiles Using the ENFEN Battery in Children Diagnosed With Attention-Deficit Hyperactivity Disorder

et al. 2020

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Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children and adolescents. People who have this disorder are characterized by presenting difficulties in the processes of sustained attention, being very active, and having poor control of their impulses. Despite the high prevalence of this disorder and the existence of various tests used for its diagnosis, few data are available regarding the usefulness and diagnostic validity of these tools. Given the difficulties that these subjects present in executive functions, the aim of this study was to evaluate whether the Neuropsychological Assessment of Executive Functions battery for Children (ENFEN, for its acronym in Spanish, Portellano et al., 2009) allows to establish specific profiles of executive performance for people with attention-deficit hyperactivity disorder (ADHD). The sample was made up of 197 participants of both sexes, aged between 6 and 12 years age (134 with a clinical diagnosis and 63 without pathology). A nonexperimental design was followed, using a comparative descriptive study method. The results indicated that the scales of phonological fluency, color path, rings, and interference are the most associated with the diagnosis of ADHD, providing data on inhibition, mental flexibility, sustained and selective attention, planning, verbal fluency, and working memory, among others. The practical implication of these results is in line with providing support in the clinical diagnosis that is carried out in children’s mental health units. In addition, the ENFEN tool can be valued as a suitable psychometric instrument in the psychoeducational field, helping professionals in a school environment to be more aware of the areas of cognitive development in which a student diagnosed with ADHD will have more difficulties and, in doing so, providing more adjusted and effective psychopedagogical measures when it comes to supporting students in their adaptation to the school environment.

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Section: Introductionmentioning

confidence: 99%

Detection of Executive Performance Profiles Using the ENFEN Battery in Children Diagnosed With Attention-Deficit Hyperactivity Disorder

et al. 2020

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“…We next determined if the developmental molecular deficits continue, or if MYT1L serves a distinct role in adult brains. As ID and ASD are not well localized in the brain, we focused on the prefrontal cortex (PFC), known to be dysregulated in human ADHD (Yasumura et al, 2019). For ATAC-seq, we discovered 4988 DARs (FDR<0.05, 9756 DARs FDR<0.1; Fig.…”

Section: Myt1l Haploinsufficiency Results In Sustained Chromatin Changes In Adult Brainmentioning

confidence: 99%

A MYT1L Syndrome mouse model recapitulates patient phenotypes and reveals altered brain development due to disrupted neuronal maturation

Chen¹,

Lambo

Ge³

et al. 2020

Preprint

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Human genetics have defined a new autism-associated syndrome caused by loss-of-function mutations in MYT1L, a transcription factor known for enabling fibroblast-to-neuron conversions. However, how MYT1L mutation causes autism, ADHD, intellectual disability, obesity, and brain anomalies is unknown. Here, we develop a mouse model of this syndrome. Physically, Myt1l haploinsufficiency causes obesity, white-matter thinning, and microcephaly in the mice, mimicking clinical phenotypes. Studies during brain development reveal disrupted gene expression, mediated in part by loss of Myt1l gene target activation, and highlight precocious neuronal differentiation as the mechanism for microcephaly. In contrast, adult studies reveal that mutation results in failure of transcriptional and chromatin maturation, echoed in disruptions in baseline physiological properties of neurons. This results in behavioral features including hyperactivity, hypotonia, and social alterations, with more severe phenotypes in males. Overall, these studies provide insight into the mechanistic underpinnings of this disorder and enable future preclinical studies.

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“…As children age into adults, working memory, planning, and problem solving become more efficient (57). Similarly, as children with ADHD age, measures of executive function improve (58). The age and overall maturity of the individual are additional variables in a decision to discontinue stimulants.…”

Section: Discussionmentioning

confidence: 99%

Intentional Discontinuation of Psychostimulants Used to Treat ADHD in Youth: A Review and Analysis

Lohr

Wanta

Baker³

et al. 2021

Front. Psychiatry

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Objectives: This paper reviews the literature on intentional discontinuation of psychostimulants in ADHD to summarize what is known about clinical course of controlled discontinuation and guide practitioners who are considering stopping these medications for youth with ADHD.Methods: A systematic search was executed in Cochrane CENTRAL, EMBASE, Psychinfo, and MEDLINE databases to identify all articles that addressed the topic of deprescribing of psychotropic medications in children and adolescents. Keywords and search strings were developed using “PICO” framework, involving Population of interest (<18 y.o.), Intervention (“discontinuation,” “deprescribing,” and synonyms), Comparator (continuation of specific medications), and Outcomes. Ten reviewers conducted the initial screen via a single reviewer system. Articles that met a set of three inclusionary criteria were selected for full text review and identification as specific to discontinuation of stimulants in ADHD.Results: The literature review identified 35 articles specifically addressing intentional deprescribing, discontinuation, tapering, or withdrawal of stimulants for children and adolescents with ADHD. In addition to providing broad support for the efficacy of stimulants to treat ADHD and reduce negative outcomes, there is a distinct population of children and adolescents with ADHD who do not relapse or deteriorate when taken off medications for ADHD. The majority of articles addressed either the re-emergence of ADHD symptoms or side effects, both desired and adverse, following discontinuation of stimulants. While confirming the ability of stimulants to treat ADHD in youth, our results support periodic consideration of trials of stopping medications to determine continued need.Conclusions: This systematic review summarizes the literature on deprescribing stimulants for ADHD in children and adolescents. Further research is needed to determine the optimal duration of treatment, identify patients that may benefit from medication discontinuation, and inform evidence-based guidelines for discontinuation when appropriate. More research is needed to understand and define the subgroup of youth who may succeed with stimulant discontinuation.

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Age-related differences in frontal lobe function in children with ADHD

Cited by 43 publications

References 27 publications

Detection of Executive Performance Profiles Using the ENFEN Battery in Children Diagnosed With Attention-Deficit Hyperactivity Disorder

Detection of Executive Performance Profiles Using the ENFEN Battery in Children Diagnosed With Attention-Deficit Hyperactivity Disorder

A MYT1L Syndrome mouse model recapitulates patient phenotypes and reveals altered brain development due to disrupted neuronal maturation

Intentional Discontinuation of Psychostimulants Used to Treat ADHD in Youth: A Review and Analysis

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