Association between symptoms and subtypes of attention‐deficit hyperactivity disorder and sleep problems/disorders

This study aimed to investigate the association between attention‐deficit hyperactivity disorder (ADHD) symptoms and subtypes, and sleep schedules, daytime inadvertent napping, and sleep problems/disorders in children and adolescents with and without ADHD. The sample included 325 patients with ADHD, aged 10–17 years [male: 81.5%; combined type (ADHD‐C): 174; predominantly inattentive type (ADHD‐I): 130; predominantly hyperactive‐impulsive type (ADHD‐HI): 21], and 257 children and adolescents without lifetime ADHD (non‐ADHD). We conducted psychiatric interviews with the participants and their mothers before making the diagnoses of ADHD, other psychiatric disorders, and sleep problems or disorders. We also collected the medication treatment data and parent and teacher reports of ADHD symptoms. Multi‐level models were used for data analyses controlling for sex, age, psychiatric comorbidities, and treatment with methylphenidate. The ADHD‐C and ADHD‐I groups had more daytime inadvertent napping. In general, the three subtypes were associated with increased rates of sleep problems/disorders. Specifically, ADHD‐C rather than ADHD‐I was associated with circadian rhythm problems, sleep‐talking, nightmares (also ADHD‐HI), and ADHD‐I was associated with hypersomnia. The most‐related sleep schedules and problems for inattention and hyperactivity‐impulsivity were earlier bedtime, later rise time, longer nocturnal sleep, more frequent daytime napping, insomnia, sleep terrors, sleep‐talking, snoring, and bruxism across informants. The findings imply that in addition to the dichotomous approach of ADHD and considering the psychiatric comorbid conditions, ADHD subtypes and symptom dimensions need to be considered in clinical practice and in the research regarding the association between ADHD and sleep problems/disorders.     

Bipolar and ADHD Comorbidity: Both Artifact and Outgrowth of Shared Mechanisms

[Clin Psychol Sci Prac 17: 350–359, 2010] Published rates of comorbidity between pediatric bipolar disorder (PBD) and attention‐deficit/hyperactivity disorder (ADHD) have been higher than would be expected if they were independent conditions, but also dramatically different across different studies. This review examines processes that could artificially create the appearance of comorbidity or substantially bias estimates of the PBD‐ADHD comorbidity rate, including categorization of dimensional constructs, overlap among diagnostic criteria, over‐splitting, developmental sequencing, and referral or surveillance biases. Evidence also suggests some mechanisms for “true” PBD‐ADHD comorbidity, including shared risk factors, distinct subtypes, and weak causal relationships. Keys to differential diagnosis include focusing on episodic presentation and nonoverlapping symptoms unique to mania.     

注意缺陷多动障碍儿童的眼动抑制缺陷对照研究

目的:探讨注意缺陷多动障碍(Attention Deficit Hyperactivity Disorder,ADHD)儿童在抑制性眼动任务中的反应特征。方法:采用注视、主动眼动及反向眼动任务对21例ADHD儿童和21例正常对照儿童进行评估。结果:(1)注视任务中,ADHD组侵入性眼跳数目高于对照组[无分心条件:(12.67±12.28)vs.(6.38±6.95),P=0.040;分心条件:(16.91±10.00)vs.(11.29±5.99),P=0.030];(2)主动眼动任务中,两组儿童眼跳参数差异无统计学意义;(3)反向眼动任务中,ADHD组眼跳方向错误率高于对照组[间隔条件:(68.14±17.85)%vs.(54.10±20.22)%,P=0.020;重叠条件:(62.49±17.54)%vs.(49.27±17.21)%,P=0.020]。结论:注意缺陷多动障碍儿童眼动抑制能力存在缺陷,推测可能是由于注意缺陷多动障碍儿童具有异常的额叶-纹状体结构和/或功能所致。     

Global motion mechanisms compensate local motion deficits in a patient with a bilateral occipital lobe lesion

Successive stages of cortical processing encode increasingly more complex types of information. In the visual motion system this increasing complexity, complemented by an increase in spatial summation, has proven effective in characterizing the mechanisms mediating visual perception. Here we report psychophysical results from a motion-impaired stroke patient, WB, whose pattern of deficits over time reveals a systematic shift in spatial scale for processing speed. We show that following loss in sensitivity to low-level motion direction WB’s representation of speed shifts to larger spatial scales, consistent with recruitment of intact high-level mechanisms. With the recovery of low-level motion processing WB’s representation of speed shifts back to small spatial scales. These results support the recruitment of high-level visual mechanisms in cases where lower-level function is impaired and suggest that, as an experimental paradigm, spatial summation may provide an important avenue for investigating functional recovery in patients following damage to visually responsive cortex.     

Role of the Medial Olivocochlear system among children with ADHD

Attention deficit hyperactivity disorder (ADHD) patients show, as one of the main symptoms, an attentional impairment. Selective attention in the hearing process is the ability to understand speech in a noisy environment, which can be evaluated by several methods. One of the main approaches is the functioning of the Medial Olivocochlear Efferent System, which can be accessed by Transient-Evoked Otoacoustic Emissions (TOAE).ObjectiveThis study aimed at evaluating the suppression effect of contralateral noise on TOAE in ADHD (study group) and normal subjects (control group). Study Design: Case-control study.Material and MethodsA study with 20 children distributed in two, age- and gender-matched groups. Results: No differences were found in TOAE responses between the two groups, with and without noise.ConclusionsWe conclude that there were no functional differences in the Medial Olivocochlear Efferent System in the two groups analyzed.     

Kalopanaxsaponins A and B isolated from Kalopanax pictus ameliorate memory deficits in mice

The stem-bark of Kalopanax pictus (KP, family Araliaceae), which contains triterpenoid saponins, has been shown to exhibit anticarcinogenic, antiinflammatory, antirheumatoid and antidiabetic activities. In a preliminary study, a KP methanol extract demonstrated acetylcholinesterase activity in vitro and memory enhancement in scopolamine-treated mice. Therefore, we isolated acetylcholinesterase inhibitors, kalopanaxsaponins A and B, from a KP butanol (BuOH) fraction, measured acetylcholinesterase activity in vitro, and investigated their memory-enhancing effects in a passive avoidance test, Y-maze test and Morris water maze test. These constituents inhibited acetylcholinesterase activity and significantly reversed scopolamine-induced deficits. They also increased brain-derived neurotrophic factor (BDNF) and phosphorylated cAMP response element binding (p-CREB) protein expression but reduced TNF-α increased by scopolamine. Based on these findings, kalopanaxsaponins A and B may ameliorate memory deficits by inhibiting acetylcholinesterase activity and inducing BDNF and p-CREB expression.     

通络化痰胶囊治疗脑梗死恢复期痰瘀阻络证353例临床研究

目的 评价通络化痰胶囊治疗脑梗死恢复期(痰瘀阻络证)的安全性及有效性.方法 采用多中心随机双盲对照方法,在7个临床试验中心筛选479例受试者,随机分为对照组121例与试验组358例,分别给予血栓心脉宁胶囊和通络化痰胶囊治疗,以神经功能缺损程度评分、中风病证候评分及血脂和血液流变学检查为疗效评价指标,以一般生命体征、血、尿、便常规检查、心电图、肝功能(丙氨酸氨基转移酶)、肾功能(血尿素氮、血肌酐)为安全性评价指标.结果 472例完成了试验,其中对照组119例,试验组353例.对照组临床神经功能缺损程度综合疗效愈显率和总有效率分别为22.69％、71.43％,试验组为37.96％、84.70％,试验组优于对照组(P＜0.01);对照组中医证候疗效愈显率和总有效率分别为30.25％、68.91％,试验组为50.99％、83.85％,试验组优于对照组(P＜0.01).治疗前后组内及治疗后组间比较,血脂及血液流变学指标差异均无统计学意义(P＞0.05).结论 通络化痰胶囊治疗脑梗死恢复期痰瘀阻络证可以较好地减少神经功能缺损症状及改善中医证候,但对血脂及血液流变学指标无明显改善作用;该药安全性较好,无明显不良反应.     

Short-term response of bone turnover to low-dose oral contraceptives in exercising women with hypothalamic amenorrhea

BACKGROUND: We examined the response of bone turnover markers and indices of energy status after 2 weeks of oral contraceptive (OC) therapy in premenopausal women with exercise-associated menstrual disturbances (EAMD). STUDY DESIGN: Six women with EAMD received one 28-day cycle of a triphasic OC containing 180-250 mcg norgestimate/25 mcg ethinyl estradiol (EAMD+OC) and six were controls (EAMD controls). Bone turnover markers amino-terminal propeptide of Type I procollagen and serum carboxy-terminal telopeptides of Type I collagen (PINP and SCTX-I) were assessed at baseline and after 2 weeks of OC therapy (EAMD+OC) or after a 30-day monitoring period (EAMD controls). Total triiodothyronine, resting energy expenditure (REE) and dietary intake were assessed as secondary end points. The absolute and percent changes from baseline in the primary and secondary outcomes were evaluated using an analysis of covariance, adjusting for baseline values of the corresponding outcome. RESULTS: Compared to EAMD controls, a significant change from baseline was observed in the EAMD+OC group for PINP (mean+/-SEM, 9.9+/-6.1 vs. -33.9+/-9.0 mcg/L; p=.005) and SCTX-I (-0.02+/-0.11 vs. -0.25+/-0.07 ng/mL; p=.017), but not osteoprotegerin (-0.53+/-0.22 vs. 0.20+/-0.44 pmol/L; p=.429) after 2 weeks (14.7+/-0.3 days) of OC therapy. Total triiodothyronine levels were elevated in the EAMD+OC group after therapy compared with EAMD controls (19.7+/-4.1 vs. -8.4+/-4.9 ng/dL; p=.002); however, no differences between groups were observed for the changes in REE or dietary intake. CONCLUSION: Our data demonstrate that 2 weeks of low-dose OC therapy rapidly reduced markers of bone resorption and formation, without any significant impact on energy status in women with EAMD.     

A fifteen-year follow-up of neurological conditions in VLBW children without overt disability: relation to gender, neonatal risk factors, and end stage MRI findings

BACKGROUND: Very low birthweight (VLBW; birthweight 相似文献