February 2010

Attention-deficit/hyperactivity Disorder is Characterized by a Delay in Cortical Maturation.

P. Shar et al, investigated the nature of the disturbance in brain development that underpins attention-deficit/hyperactivity (ADHD). It was unclear as to whether ADHD results from a delay in brain maturation, or whether it represents a complete diviation from typical development. They estimated cortical thickness at 40,000 cerebral points from 824 magnetic resonance scans. From 223 children with ADHD and 223 typically developing controls.

They were able to define the growth trajectory of each cortical point, delineating a phase of childhood increase followed by adolescent decrease in cortical thickness. From these trajectories the age of attaining peak cortical  thickness was derived and used as an index of cortical maturation.
They found maturation to progress in a similar manner regionally in both the children with and without ADHD.
However there was a marked delay in those with ADHD attaining peak thickness throughout the cerebrum.

Attention-deficit/hyperactivity Disorder is Characterized by a Delay in Cortical Maturation. P.Shar, K. Eckstrand, W. Sharp, J. Blumernthal, J.P. Lerch, d. Greenstein, L. Clasen, A. Evens, J. Giedd and J.L. Rapoport.

January 2010

Association Between Adult Attention Deficit/Hyperactivity Disorder and Obesity in the US Population

Sherry et al was interested in studying the association between ADHD and overweight and obesity in the US population. They used the data from the Collaborative Psychiatric Epidemiology Surveys. They used some 6,735 US residents in their attempts to examine the relationship.

Sherry et al  used a retrospective assessment of childhood ADHD and a self-reported assessment of adult ADHD. This result were defined by three categories. Those who never met the criteria, those who met the full childhood criteria and who had current symptoms.

They found that the prevalence of overweight and obesity was 33.9 and 29.4% respectively, among person with now history of ADHD. And that adult ADHD was associated with a greater likelihood of overweight.

Association between Adult Attention Deficit/Hyperactivity Disorder and Obesity in the US Population. Sherry L. Pagoto, Carol Curtin, Stephenie C. Lemon Linda G Brandini, Kirstin L. Schneider, Jamies S. Bodenlos and Yunsheng Ma. Obesity (2009) 17 3, 539–544. doi:10.1038/oby.2008.587

Decreased Calloral Thickness in Attention-Deficit/Hyperactivity Disorder.

Luders et al, noticed that one the most replicated alterations is a significantly smaller corpus callosum (CC) and that conflicting reports existed with the affected callosal segments.

They applied novel surface-based geometrical modeling methods to establish the presence, direction, and exact location of callosum alterations in ADHD at high spatial resolution. They used an age-matched males, one group of nineteen with ADHD and 19 controls.

Luders et al found that decreased callosal thickness may be associated with fewer fibers or a decrease in the myelination of fibers connecting the parietal and prefrontal cortices. This This might affect interhemispheric communication channels that are necessary to sustain attention or motor control, thus contributing to symptoms of hyperactivity and impulsivity, or inattention, observed in ADHD.

Decreased Calloral Thickness in Attention-Deficit/Hyperactivity Disorder. E. Luders, K. Narr, L.Hamilton, O.Phillips, P. Thompson, J. Valle, M. Del'Homme, T. Strickland, J. McCraken, A. Toga. Biological Psychiatry, Volume 65, Issure 1. pages 84-88

December 2009

Comorbid ADHD is associated with altered patterns of neuronal activation in adolescents with bipolar disorder performing a simple attention task.

Caleb et al investigated the neurophysiological relationship between ADHD and Bipolar Disorder.

They recruited eleven adolescents with Bipolar and comorbid ADHD. And 15 adolescents with Bipolar Disorder and no ADHD. These two groups participated in fMRI scans. They found that Bipolar Disorder with ADHD was associated with less activation in the ventrolateral prefrontal cortex and anterior cingulate with greater activation in the posterior cortex.

Adler et al The pattern of differences between concluded the adolescents with ADHD and comorbid Bipolar Disorder demonstrated decreased activation of the prefrontal regions, when compared with the Bipolar Adolescents with ADHD the pattern of differences between Bipolar adolescents with comorbid ADHD

BIPOLAR DISORDERS Comorbid ADHD is associated with altered patterns of neuronal activation in adolescents with bipolar disorder performing a simple attention task Caleb M Adler , Melissa P DelBello , Neil P Mills , Vince Schmithorst , Scott Holland and Stephen M Strakowski Volume 7 Issue 6, Pages 577 – 588 Published Online: 8 Dec 2005 Journal compilation © 2009 John Wiley & Sons A/S

Risperidone treatment for ADHD in children and adolescents with bipolar disorder

Biederman et al, as children and adolescents with Bipolar Disorder have high risk of comorbid attention-deficit hyperactivity disorder (ADHD). Biederman et al wanted to examine if there was any improvement in the ADHD symptoms of children and adolescents with Bipolar Disorder using risperidone monotherapy.

They conducted an open-label study of risperidone monotherapy for the treatment of pediatric Bipolar Disorder. 31 children and adolescents with both ADHD and Bipolar Disorder particapted.

Biederman et al found that the improvement in ADHD symptoms was contingent on improvement in manic symptoms, although both hyperactive/impulsive and inattentive symptoms were significantly improved with risperidone.

Biederman concluded that risperidone was associated with tangible but modest improvement of symptoms of ADHD in children with Bipolar Disorder.

Risperidone treatment for ADHD in children and adolescents with bipolar disorder Joseph Biederman, Paul Hammerness, Robert Doyle, Gagan Joshi, Megan Aleardi, and Eric Mick Published online 2008 February. Neuropsychiatr Dis Treat. 2008 February; 4(1): 203–207. Copyright © 2008 Biederman et al.

November 2009

A Randomized, Double-Blind, Placebo-Controlled Study of Guanfacine Extended Release in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

Biederman et al, were interested in assessing the efficacy and safety of extended release guanfacine (Tenex) , when compared to a placebo. For the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD)

Parcipants aged between 6 and 17 were randomly assigned to one of three treatment groups, one group were given guanfacine extended release, a placebo and the third group were used as controls.

The most commonly reported adverse effects were headache, somnolence (tiredness) fatigue, upper abdominal pain and sedation. There was also small to moderate changes in blood pressure and pulse rate.

Biederman et al concluded that guanfacine extended release met the primary and secondry efficacy end points. And was well tolerated in effective when compared with the placebo.

A Randomized, Double-Blind, Placebo-Controlled Study of Guanfacine Extended Release in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder
Joseph Biederman, MDa, Raun D. Melmed, MDb, Anil Patel, MDc, Keith McBurnett, PhDd, Jennifer Konow, RNe, Andrew Lyne, MSc, CStatf, Noreen Scherer, BA. PEDIATRICS Vol. 121 No. 1 January 2008, pp. e73-e84 (doi:10.1542/peds.2006-3695)

October 2009

Untreated ADHD in Adults:Are There Sex Differences in Symptoms, Comorbidity, and Impairment?

Kirsten Rasmussen and Sten Levander examined some 600 ADHD patients from Norway. They looked at general background, diagnosic and social history. These symptom profiles were compared between those who had not been previously treated. They found that of those who had not been previously treated 20% fell outside society's ordinary vocational activities or social benefit system. Most patients had the combined type of ADHD. With one third the inattentive type. There were only 2% with the hyperactive/impulsive subtype. They found that abuse and criminality were more common among men, while affective, eating, and somatization disorders were more common among women. Otherwise there was few sex differences found. Kirsten Rasmussen and Sten Levander concluded that ADHD intensity of symptoms and subtypes did not differ between the sexes and was unrelated to age. Symptom intensity was linked to criminalty, abuse and other pshchiatric problems. Untreated ADHD in Adults Are There Sex Differences in Symptoms, Comorbidity, and Impairment? Kirsten Rasmussen, Sten Levander.Journal of Attention Disorders, Vol. 12, No. 4, 353-360 (1 January 2009)

Effective Methylphenidate Treatment of an Adult Aspergers Syndrome and a Comorbid ADHD.

Mandy Roy et al were interested in Aspergers Syndrome presenting as a comorbid disorder with ADHD. There has been very few cases of assessment and treatment of these comorbid disorders in adulthood. Mandy Roy et al, examined a twenty six year old patients with ADHD in combination with Aspergers Syndrome. They started treatment with methylphenidate and obverved the patient’s clinical responses. Psychological tests were carried out, such as attention,and a functional magnetic resonance imaging examination was preformed while the patient was proforming an attention task. They found with the examination by MRI there was a reduction of cerebrao activity bilaterally in the parietal lobe under the influence of methylphenidate. They concluded that in this particular instance, that there was complex impairment by the combination of ADHD and Aspergers syndrome and there were broad social and behavioral benefits of treatment with methylphenidate for this particular comorbidity.

Mandy Roy, Wolfgang Dillo, Svenja Bessling, Hinderk M. Emrich and Martin D. Ohlmeier Journal of Attention Disorders, Vol. 12, No. 4, 381-385 (2009