Attention Deficit Hyperactivity Disorder (ADHD): A Complex Lifetime Story

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Developmental Neuroscience".

Deadline for manuscript submissions: closed (15 February 2019) | Viewed by 25097

Special Issue Editor


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Guest Editor
Department of Pediatrics, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France
Interests: ADHD; chronobiology; biostatistics; psychometrics

Special Issue Information

Dear Colleagues,

Attention-Deficit with Hyperactivity Disorder (ADHD) is a complex neurodevelopmental disorder affecting about 5% of school-age children that persists at adulthood in about 60% of the cases. The biological and genetic origins of ADHD are widely admitted although the pathophysiological paths are still not that clear besides neuropsychological issues like the lack of inhibition and mind wandering. Several regions of the central nervous system seem to be involved, from the prefrontal cortex to the cerebellum.

Contrasting with the huge number of scientific papers and books on ADHD published in the last four decades, this condition remains under-recognized in some countries. Barriers to care and all form of stigma result and need to be addressed. Governments and other health care stakeholders are not aware of the costs for the health systems and the society. Words must be backed by deeds.

At all age, ADHD is associated with a variety of psychiatric comorbid disorders (e.g., mood and anxiety disorders, substance and non-substance abuse disorders, learning disorders) and non-psychiatric comorbid disorders (e.g. epilepsy, enuresis, atopic disease) that make the clinical presentation sometimes difficult to decipher. Not to mention the co-occurrence of Autism Spectrum Disorder and ADHD. An early and comprehensive diagnosis and a multidisciplinary treatment—including pharmacological ones—are warranted to shift the life trajectory, prevent the apparition of comorbid disorders and damper the multifaceted burden on the patient and its family. The challenge for the clinician taking care of a patient with ADHD is to take into consideration and treat this myriad of issues. It shall be kept in mind that a fatal issue may not be excluded: Untreated ADHD is now recognized as a cause for domestic and driving accidents, (repeated) suicidal attempts and suicide. Nowadays, it is not regarded as bad practice to associate a psychostimulant with an antidepressant, a mood stabilizer or a new antipsychotic agent to the treatment of patients with comorbid ADHD. Nevertheless, clinical studies and evidence-based guidelines are needed. The evaluation of non-pharmacological treatments like mindfulness and neurofeedback—as stand-alone or add-on therapies—has to be encouraged. Finally, the issue of transition from child to adult healthcare services has been raised in the recent years, and guidelines and programs have been proposed.

The current Special Issue will gather reviews and articles on the understanding, pathogenesis and direction for treatment of ADHD and related disorders in children and adults. Topics of interest include, but are not limited to: Genetics, epigenetics, psychiatric and non-psychiatric comorbidity, biomarker discovery, pharmacological and non-pharmacological therapeutic interventions, stigma reduction, and transition.

Dr. Hervé Caci
Guest Editor

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Keywords

  • Comorbidity
  • Suicidal behavior
  • Stigma
  • Treatment
  • Prevention
  • Transition

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Published Papers (4 papers)

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15 pages, 447 KiB  
Article
Design Fluency in Children with ADHD and Comorbid Disorders
by Anaïs Fournier, Bruno Gauthier, Marie-Claude Guay and Véronique Parent
Brain Sci. 2020, 10(3), 172; https://doi.org/10.3390/brainsci10030172 - 17 Mar 2020
Cited by 6 | Viewed by 4150
Abstract
Background: Attention deficit/hyperactivity disorder (ADHD) is often associated with frontal executive impairment in children. Oppositional defiant disorder (ODD) and anxiety disorders (AD) frequently accompany ADHD, but the impact of these comorbid disorders on cognition remains elusive. The five-point test (FPT), a design fluency [...] Read more.
Background: Attention deficit/hyperactivity disorder (ADHD) is often associated with frontal executive impairment in children. Oppositional defiant disorder (ODD) and anxiety disorders (AD) frequently accompany ADHD, but the impact of these comorbid disorders on cognition remains elusive. The five-point test (FPT), a design fluency task, has been shown to be sensitive to neurological damage, specifically to frontal lobe lesions in patients with brain injuries. The purpose of this study was to compare the performances of neurotypical children with that of children with ADHD, ADHD-ODD, and ADHD-AD on the FPT in order to examine whether these groups could be distinguished from one another based on their cognitive profile. Methods: A total of 111 children aged 8 to 11 years old participated in the study. Six measures from the FPT were used to characterize their performance. Results: Statistically significant differences between groups were observed for five of the six FPT measures. Essentially, children with ADHD-ODD made more repeated designs than the three other groups (control p > 0.001, ADHD p = 0.008, ADHD-AD p = 0.008), while children with ADHD-AD produced fewer total and correct designs than the control and ADHD groups (p = 0.009). Conclusions: This suggests that comorbidities have an additive impact on the cognitive profile of children with ADHD. Design fluency may be a sensitive measure for capturing the subtle cognitive deficits that are likely to be involved in these disorders. Full article
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15 pages, 2160 KiB  
Article
Integrated Analysis of microRNA and mRNA Expression Profiles: An Attempt to Disentangle the Complex Interaction Network in Attention Deficit Hyperactivity Disorder
by Nicoletta Nuzziello, Francesco Craig, Marta Simone, Arianna Consiglio, Flavio Licciulli, Lucia Margari, Giorgio Grillo, Sabino Liuni and Maria Liguori
Brain Sci. 2019, 9(10), 288; https://doi.org/10.3390/brainsci9100288 - 22 Oct 2019
Cited by 31 | Viewed by 5023
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a childhood-onset neurodevelopmental disorder, whose etiology and pathogenesis are still largely unknown. In order to uncover novel regulatory networks and molecular pathways possibly related to ADHD, we performed an integrated miRNA and mRNA expression profiling analysis in [...] Read more.
Attention Deficit Hyperactivity Disorder (ADHD) is a childhood-onset neurodevelopmental disorder, whose etiology and pathogenesis are still largely unknown. In order to uncover novel regulatory networks and molecular pathways possibly related to ADHD, we performed an integrated miRNA and mRNA expression profiling analysis in peripheral blood samples of children with ADHD and age-matched typically developing (TD) children. The expression levels of 13 miRNAs were evaluated with microfluidic qPCR, and differentially expressed (DE) mRNAs were detected on an Illumina HiSeq 2500 genome analyzer. The miRNA targetome was identified using an integrated approach of validated and predicted interaction data extracted from seven different bioinformatic tools. Gene Ontology (GO) and pathway enrichment analyses were carried out. Results showed that six miRNAs (miR-652-3p, miR-942-5p, let-7b-5p, miR-181a-5p, miR-320a, and miR-148b-3p) and 560 genes were significantly DE in children with ADHD compared to TD subjects. After correction for multiple testing, only three miRNAs (miR-652-3p, miR-148b-3p, and miR-942-5p) remained significant. Genes known to be associated with ADHD (e.g., B4GALT2, SLC6A9 TLE1, ANK3, TRIO, TAF1, and SYNE1) were confirmed to be significantly DE in our study. Integrated miRNA and mRNA expression data identified critical key hubs involved in ADHD. Finally, the GO and pathway enrichment analyses of all DE genes showed their deep involvement in immune functions, reinforcing the hypothesis that an immune imbalance might contribute to the ADHD etiology. Despite the relatively small sample size, in this study we were able to build a complex miRNA-target interaction network in children with ADHD that might help in deciphering the disease pathogenesis. Validation in larger samples should be performed in order to possibly suggest novel therapeutic strategies for treating this complex disease. Full article
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13 pages, 387 KiB  
Article
The Relationship between Adult Symptoms of Attention-Deficit/Hyperactivity Disorder and Criminogenic Cognitions
by Paul E. Engelhardt, Gavin Nobes and Sophie Pischedda
Brain Sci. 2019, 9(6), 128; https://doi.org/10.3390/brainsci9060128 - 2 Jun 2019
Cited by 7 | Viewed by 7436
Abstract
The relationship between ADHD—in particular hyperactivity—and criminal behavior is well documented. The current study investigated the role of criminogenic cognitions in the explanation of this relationship by examining which symptoms of ADHD are associated with criminogenic cognitions. Community-recruited adults (N = 192) [...] Read more.
The relationship between ADHD—in particular hyperactivity—and criminal behavior is well documented. The current study investigated the role of criminogenic cognitions in the explanation of this relationship by examining which symptoms of ADHD are associated with criminogenic cognitions. Community-recruited adults (N = 192) completed self-report questionnaires for symptoms of ADHD and criminogenic cognitions. Symptoms of inattention were consistently and strongly related to criminogenic cognitions. In particular, inattention was significantly related to cutoff, cognitive indolence, and discontinuity. There was also evidence that impulsivity was positively related to criminogenic cognitions, and specifically, to the power orientation subscale. In contrast, and contrary to expectations, symptoms of hyperactivity were not related to criminogenic cognitions. These results indicate that in community-recruited adults, inattention rather than hyperactivity is related to criminogenic cognitions. We discuss the implications of these findings contrasting with those of previous studies that used forensic and clinical samples. Full article

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12 pages, 215 KiB  
Perspective
The Association between ADHD and Obesity: Intriguing, Progressively More Investigated, but Still Puzzling
by Samuele Cortese
Brain Sci. 2019, 9(10), 256; https://doi.org/10.3390/brainsci9100256 - 27 Sep 2019
Cited by 72 | Viewed by 7612
Abstract
This narrative review is aimed at presenting the most recent evidence on the association between attention-deficit/hyperactivity disorder (ADHD) and obesity. The review is informed by previous relevant systematic reviews and a search in Pubmed and PsycINFO up to 1 August 2019. Although the [...] Read more.
This narrative review is aimed at presenting the most recent evidence on the association between attention-deficit/hyperactivity disorder (ADHD) and obesity. The review is informed by previous relevant systematic reviews and a search in Pubmed and PsycINFO up to 1 August 2019. Although the association between ADHD and obesity would seem, at first, paradoxical, in the past two decades there has been an increasing number of studies on this topic. The present review shows that there is meta-analytic evidence supporting a significant association between these two conditions, at least in adults. Growing evidence is also being published on the genetic and environmental factors underlying the association. However, the cause–effects paths, as well as the exact mechanisms explaining the association, remain unclear. Additionally, empirical evidence guiding the management/treatment of patients with the two conditions is still limited. Therefore, after almost 20 years from the first report of a link between ADHD and obesity, this association continues to be puzzling. Full article
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