Omega-3 Fatty Acids are Related to Abnormal Emotion Processing in Adolescent Boys with Attention Deficit Hyperactivity Disorder

Background In addition to the core symptoms, attention deficit hyperactivity disorder (ADHD) is associated with poor emotion regulation. There is some evidence that children and young adults with ADHD have lower omega-3 levels and that supplementation with omega-3 can improve both ADHD and affective symptoms. We therefore investigated differences between ADHD and non-ADHD children in omega-3/6 fatty acid plasma levels and the relationship between those indices and emotion-elicited event-related potentials (ERPs). Methods Children/adolescents with (n=31) and without ADHD (n=32) were compared in their plasma omega-3/6 indices and corresponding ERPs during an emotion processing task. Results Children with ADHD had lower mean omega-3/6 and ERP abnormalities in emotion processing, independent of emotional valence relative to control children. ERP abnormalities were significantly associated with lower omega-3 levels in the ADHD group. Conclusions The findings reveal for the first time that lower omega-3 fatty acids are associated with impaired emotion processing in ADHD children.

Omega-3 Fatty Acids are Inversely Related to Callous and Unemotional Traits in Adolescent Boys with Attention Deficit Hyperactivity Disorder

A number of research studies have reported abnormal plasma fatty acid profiles in children with ADHD along with some benefit of n−3 to symptoms of ADHD. However, it is currently unclear whether (lower) long chain-polyunsaturated fatty acids (LC-PUFAs) are related to ADHD pathology or to associated behaviours. The aim of this study was to test whether (1) ADHD children have abnormal plasma LC-PUFA levels and (2) ADHD symptoms and associated behaviours are correlated with LC-PUFA levels. Seventy-two, male children with (n=29) and without a clinical diagnosis of ADHD (n=43) were compared in their plasma levels of LC-PUFA. Plasma DHA was higher in the control group prior to statistical correction. Callous–unemotional (CU) traits were found to be significantly negatively related to both eicosapentaenoic acid (EPA), and total omega-3 in the ADHD group. The findings unveil for the first time that CU and anti-social traits in ADHD are associated with lower omega-3 levels.

Attention Deficit Hyperactivity Disorder and Executive Function Impairment: An Overview.

As with any cognitive ability, attention is vulnerable to dysfunction. The most common attentional problem is attention deficit hyperactivity disorder (ADHD). This brief overview will highlight the symptoms and deficits associated with ADHD, its prevalence in today’s society, the association between executive function impairment and ADHD using Barkley’s (1997) work, and the personal and societal effects of the disorder.

Acute Transient Stress Induced Adrenal Hypertrophy and Adrenal Medullary Hyperactivity

Objectives: Adrenal gland hypertrophy can be related to acute stress with abnormal adrenal function tests. It may not always need treatment. Material and methods: An acute presentation of adrenal gland hypertrophy following an abdominal emergency, with subsequent hypoadrenalism was investigated. Results: Adrenal medullary and cortical function fully recovered without treatment. Conclusions: We postulate that the adrenal glands became enlarged and hypertrophied during an acute stress event, possibly caused by acute adrenal medullary hypersecretion and subsequent cortical hyposecretion. A wait and watch policy should be followed if no other clinical symptoms and signs of adrenal disease are present. CT scan remains an important diagnostic tool.

Cognitive and structural aspects of addiction: Relation between iris patterns, time perception, eyeblink rate, impulsivity and cigarette addiction

Objectif : Le but de ce travail est d'étudier les corrélations existantes entre les patterns de l'iris, la perception du temps et la fréquence de clignement des paupières (eye blink rate) et ceci en relation avec l'addiction à la cigarette. Méthodologie: Revue de la littérature existante. Expériences sur une cohorte d'au moins trente sujets fumeurs/non-fumeurs. Analyses statistiques. Résultats: Nos résultats confirment qu'il existe des relations entre l'impulsivité, les patterns d'iris, l'eye blink rate spontané et la perception du temps. Nous observons également que l'addiction à la cigarette et son niveau de dépendance ont une influence sur ces différentes mesures. En effet, les sujets fumeurs tendent à avoir une personnalité plus impulsive par rapport aux sujets contrôles. On remarque également une nette diminution de l'eye blink rate dans le groupe des fumeurs et une tendance à la sur-estimation du temps qui passe. Conclusion : Ce travail nous permet de mieux comprendre les différentes corrélations qui existent entre les différentes variables que nous avons mesurées (patterns d'iris, score d'impulsivité et eye blink rate) ainsi que leur relation à l'addiction à la cigarette. Dès lors qu'il est avéré que les fumeurs peuvent avoir une perception du temps altérée par rapport au groupe contrôle, il serait intéressant d'en étudier l'évolution sur le long terme (aggravation avec la durée du tabagisme actif) ainsi que les conséquences qui en découlent écologiquement au moyen d'études longitudinales et de terrain.

A model of increased impulsivity in rats with bilateral parkinsonism treated with Pramipexole

Impulse control disorders (ICD) is a common side effect of the dopaminergic treatment in patients with Parkinson's disease, which is more associated with dopamine agonists than with levodopa. To understand its pathophysiology, reliable animal models are essential. Using the variable delay-to-signal (VDS) paradigm, impulsivity was evaluated in bilateral parkinsonian rats treated with pramipexole (PPX). In this test, rats have to introduce the snout into a nose poke that is signaled by a light (presented at variable delays) triggering the delivery of a food reward after a correct response. Reaching a stable baseline performance, a partial bilateral dopaminergic lesion with 6-OHDA was induced in the dorsolateral striatum (AP: +1mm, L: ±3.4mm, V:-4.7 mm, Bregma). Rats undertook the VDS test under 5 conditions: basal state, 6-OHDA-induced lesion, the effect of two doses of PPX (0,25mg/kg and 3mg/kg; Latin-square design), and the day after the last dose of PPX. Only the acute administration of 3 mg/kg of PPX significantly rised the number of premature responses, indicating an increase of impulsive behavior, in parkinsonian but not in sham rats. Both doses of PPX significantly decreased the accuracy of responding (correct/total number of responses) and increased the incorrect and perseverative (compulsive behavior) responses in both parkinsonian and sham treated groups when compared with saline-treated groups. In conclusion, PPX induced attention deficit (lack of accuracy) as well as compulsive behavior in control and parkinsonian rats, but increased impulsivity only in the parkinsonian animals. This model could constitute a valid tool to investigate the pathophysiology of ICD.

Risperidone Versus Methylphenidate in Treatment of Preschool Children With Attention-Deficit Hyperactivity Disorder

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric diagnosis among preschool children. Objectives: The aim of this study was to examine the Risperidone treatment compared to Methylphenidate (MPH) in preschool children with ADHD. Patients and Methods: Thirty three outpatient preschool children, aged 3-6 years, diagnosed with ADHD (The diagnosis of ADHD was established by two child and adolescent psychiatrists according to the DSM-IV-TR criteria), participated in a 6-week, double-blind clinical trial with risperidone (0.5-1.5 mg/d) and methylphenidate (5-20 mg/d), in two divided doses. Treatment outcomes were assessed using the Parent ADHD Rating Scale and Conners Rating Scale. Patients were assessed by a child psychiatrist at baseline, 2, 4 and 6 weeks after the medication started. Side effects were also rated by side effects questionnaire. Results: There were no significant differences between the two protocols on the Parent ADHD Rating Scale scores (P > 0.05) and Parent Conners Rating Scale scores (P > 0.05). Both groups showed a significant improvement in ADHD symptoms over the 6 weeks of treatment for parent ADHD Rating Scale (P < 0.001) and Parent Conners Rating Scale (P < 0.001). The most common adverse effects seen with risperidone were daytime drowsiness and anorexia (20%), and with methylphenidate it was anorexia (55%). Conclusions: Results of this study show that risperidone may be effective and well tolerated for ADHD in preschool children, but more researches are needed to clarify the potential benefits and adverse effects in long term use and comorbid conditions.

The Effect of Stress Management Program Using Cognitive Behavior Approach on Mental Health of the Mothers of the Children With Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder is one of the most common psychiatric disorders in children. Objectives: The study aimed to evaluate the effectiveness of stress management program using cognitive behavior approach on mental health of the mothers of the children with attention deficit hyperactivity disorder. Patients and Methods: In this interventional study, 90 mothers of the children with attention deficit hyperactivity disorder were randomly allocated into three intervention, placebo, and control groups. The general health questionnaire was used to measure mental health. Besides, stress was assessed through the depression-anxiety-stress scale. The two instruments were completed at baseline, immediately after, and one month after the intervention by the mothers. Afterwards, within group comparisons were made using one-sample repeated measurement ANOVA. One-way ANOVA was used for inter group comparisons. Mothers in the placebo group only participated in meetings to talk and express feelings without receiving any interventions. Results: At the baseline, no significant difference was found among the three groups regarding the means of stress, anxiety, depression, and mental health. However, a significant difference was observed in the mean score of stress immediately after the intervention (P = 0.033). The results also showed a significant difference among the three groups regarding the mean score of mental health (P < 0.001). One month after the intervention, the mean difference of mental health score remained significant only in the intervention group (P < 0.001). Conclusions: The study findings confirmed the effectiveness of stress management program utilizing cognitive behavior approach in mental health of the mothers of the children with attention deficit hyperactivity disorder.

Attention Deficit Hyperactivity Disorder in a Patient With Congenital Mirror Movement Disorder and Colpocephaly

Introduction: Congenital mirror movement disorder designates involuntary movements on one side of the body that occur as mirror of the intentional movements on the contralateral side. Colpocephaly is described as persistence of fetal configuration of lateral ventricles. Case Presentation: A two-month old male infant was brought to the hospital due to bilateral identical movements of the hands. Except for bilateral involuntary synkinetic imitative movements in hands, neurological and physical examination was normal. Cranial MRI showed corpus callosum dysgenesis, hypogenesis and dilation of bilateral lateral ventricular posterior horns (colpocephaly). At the age of 7 years, he was started to use metylphenydate to mitigate attention deficit and hyperactivity disorder. The mirror movements were decreasing in amplitude by years and were not so serious to affect normal life activities. Conclusions: Mirror movements, diagnosed usually during childhood, may be congenital or secondary to neurological diseases. Although they generally do not affect normal life activities, in some cases severity of mirror movements causes a real debilitating disease. In our case the patient was diagnosed at the age of 2 months and on follow-up no debilitating problems were observed. This is the first case to describe the association of colpocephaly and mirror movements. The exact mechanism of this association is not known. Although it is known that mirror movements may be in relation with some pychiatric pathologies, this is the first report of attention deficit and hyperactivity disorder in conjunction with mirror movements and/or colpocephaly. Managing comorbidities, either physical or psyhchological, will help the patient to live in good health without trying to cope with other pathological diseases.

L’étiologie des différences individuelles dans le contrôle de soi à la petite enfance : une étude des facteurs génétiques et environnementaux

Contexte et objectifs. Le contrôle de soi serait, selon Gottfredson et Hirschi (1990), le meilleur prédicteur de la délinquance. Il serait déterminé, selon les auteurs, exclusivement par les facteurs environnementaux (compétences parentales, surveillance et punition) et ce, avant l'âge de sept ans. Il ne serait pas question des facteurs génétiques dans l'étiologie du contrôle de soi. Or, plusieurs études récentes menées à l'adolescence et à l'âge adulte avancent que le contrôle de soi serait d'origine partiellement génétique. Deux objectifs seront poursuivis. D'abord, considérant que le contrôle de soi, tel que décrit par Gottfredson et Hirschi (1990), n'ait jamais été étudié spécifiquement à la petite enfance, il a été nécessaire d'opérationnaliser le construit à la petite enfance à partir des informations existantes sur le contrôle de soi. Ensuite, il s'agira d'estimer l’influence relative des facteurs génétiques et environnementaux sur le contrôle de soi à 18, 30 et 48 mois. Méthodologie. En tout, 672 familles de jumeaux monozygotes ou dizygotes de la grande région métropolitaine de Montréal ont pris part à l'Étude des jumeaux nouveau-nés du Québec. Les items utilisés proviennent du Child Behavior Checklist (Achenbach, 1994) et ont été obtenus via les parents des jumeaux. La zygotie a été évaluée à l’aide du Zygosity Questionnaire for Young Twins (Goldsmith, 1991) et le sexe a été déterminé par les assistants de recherché. Trois temps de mesures furent étudiés : 18 mois (n = 664), 30 mois (n = 617) et 48 mois (n = 531). Résultats. Les résultats des analyses factorielles confirmatoires suggèrent par le biais des estimés qu'il soit possible de générer un facteur du contrôle de soi à la petite enfance à partir des indicateurs sélectionnés et que ceux-ci se regroupent sous l'égide d'un seul facteur. Les résultats concernant l’étiologie montrent que les différences individuelles observées seraient, majoritairement influencées par les facteurs génétiques (additifs ou de dominance) suivis par les environnements uniques. Conclusion. Les résultats suggèrent que les facteurs génétiques jouent un rôle important dans l’étiologie des différences individuelles dans le contrôle de soi tôt dans le développement alors que les environnements communs ne seraient pas impliqués. Les résultats sont compatibles avec les études menées à l'adolescence et à l'âge adulte et sont en contradiction avec les postulats de Gottfredson et Hirschi (1990).

The Effect of a Multi-Component Consultation Intervention on the Pragmatic Language Skills of Students with Symptoms of Attention Deficit Hyperactivity Disorder

The purpose of this research was to determine if a multi-component consultation intervention was effective in improving pragmatic performance in students with ADHD. Participants for this study consisted of 7 children for whom 3 data points were obtained by a parent or 2 data points by a teacher. Changes in pragmatic performance were measured by comparing reports provided by parents or teachers pre- and post- intervention. Descriptive analysis procedures were completed to summarize changes in pragmatic behavior. Results revealed the mean overall change in pragmatic behavior for children in the MCC condition (Χ=1.133) was greater than the change seen in the CAU condition (.334) after 2 months of intervention as per parent reported data. Data indicated improvement in each behavior but incongruence between teachers and parents was found. Results support the hypothesis that the multi-component consultation intervention is effective in improving the pragmatic language performance of children with ADHD.

L’étiologie des différences individuelles dans le contrôle de soi à la petite enfance : une étude des facteurs génétiques et environnementaux

Contexte et objectifs. Le contrôle de soi serait, selon Gottfredson et Hirschi (1990), le meilleur prédicteur de la délinquance. Il serait déterminé, selon les auteurs, exclusivement par les facteurs environnementaux (compétences parentales, surveillance et punition) et ce, avant l'âge de sept ans. Il ne serait pas question des facteurs génétiques dans l'étiologie du contrôle de soi. Or, plusieurs études récentes menées à l'adolescence et à l'âge adulte avancent que le contrôle de soi serait d'origine partiellement génétique. Deux objectifs seront poursuivis. D'abord, considérant que le contrôle de soi, tel que décrit par Gottfredson et Hirschi (1990), n'ait jamais été étudié spécifiquement à la petite enfance, il a été nécessaire d'opérationnaliser le construit à la petite enfance à partir des informations existantes sur le contrôle de soi. Ensuite, il s'agira d'estimer l’influence relative des facteurs génétiques et environnementaux sur le contrôle de soi à 18, 30 et 48 mois. Méthodologie. En tout, 672 familles de jumeaux monozygotes ou dizygotes de la grande région métropolitaine de Montréal ont pris part à l'Étude des jumeaux nouveau-nés du Québec. Les items utilisés proviennent du Child Behavior Checklist (Achenbach, 1994) et ont été obtenus via les parents des jumeaux. La zygotie a été évaluée à l’aide du Zygosity Questionnaire for Young Twins (Goldsmith, 1991) et le sexe a été déterminé par les assistants de recherché. Trois temps de mesures furent étudiés : 18 mois (n = 664), 30 mois (n = 617) et 48 mois (n = 531). Résultats. Les résultats des analyses factorielles confirmatoires suggèrent par le biais des estimés qu'il soit possible de générer un facteur du contrôle de soi à la petite enfance à partir des indicateurs sélectionnés et que ceux-ci se regroupent sous l'égide d'un seul facteur. Les résultats concernant l’étiologie montrent que les différences individuelles observées seraient, majoritairement influencées par les facteurs génétiques (additifs ou de dominance) suivis par les environnements uniques. Conclusion. Les résultats suggèrent que les facteurs génétiques jouent un rôle important dans l’étiologie des différences individuelles dans le contrôle de soi tôt dans le développement alors que les environnements communs ne seraient pas impliqués. Les résultats sont compatibles avec les études menées à l'adolescence et à l'âge adulte et sont en contradiction avec les postulats de Gottfredson et Hirschi (1990).

Intervenção do professor titular da sala de aula do primeiro ano do primeiro ciclo perante a inclusão de crianças com Perturbação de Hiperatividade e Défice de Atenção

A Perturbação de Hiperatividade e Défice de Atenção possui três características essenciais: Défice de Atenção, Impulsividade e Hiperatividade. Ou seja, é uma problemática neuro-comportamental, manifestada na infância onde as crianças ostentam um modelo comportamental assente no excesso de atividade motora (hiperatividade), de falta de atenção e de impulsividade. Torna-se necessário então que, o professor adopte estratégias de trabalho com estas crianças facilitando assim a sua inclusão. Este estudo tem como principais objetivos: Identificar as opiniões do professor titular da sala de aula do primeiro ano do primeiro ciclo perante a inclusão de crianças com PHDA; Descrever as estratégias do professor titular da sala de aula do primeiro ano do primeiro ciclo perante a inclusão de crianças com PHDA. A orientação metodológica adotada relaciona-se com uma abordagem qualitativa. Este estudo é constituído por 10 professores a quem foi feita uma entrevista para se recolherem os dados. Foi feito o tratamento dos dados, os quais foram analisados e discutidos. As conclusões indicam que, ao nível da formação inicial, as Escolas de Ensino Superior e as Universidades devem incorporar nos seus cursos de Professores do Primeiro Ciclo uma disciplina que aborde exaustivamente, em cada semestre, as Necessidades Educativas Especiais, abrangendo não só a teoria, como também a prática. Sugere-se ainda que exista formação contínua no âmbito das NEE, a começar pelo professor logo após o término do curso superior, independentemente da sua situação profissional, e em cada área escolar, antes do início do ano letivo, depois das turmas estarem formadas, por forma a cada docente participar naquela onde se abordará a NEE ou as NEEs que existirão na sua sala, sendo focadas estratégias de trabalho com estas crianças visando o sucesso escolar. Constatou-se também que a maioria dos entrevistados leva a cabo práticas de integração e de inclusão, embora se perceba alguma confusão entre integração e inclusão.

Adipokines: Novel Players In Resistant Hypertension.

Resistant hypertension (RH) is a multifactorial disease, frequently associated with obesity and characterized by blood pressure above goal (140/90 mm Hg) despite the concurrent use of ≥3 antihypertensive drugs of different classes. The mechanisms of obesity-related hypertension include, among others, aldosterone excess and inflammatory adipokines, which have demonstrated a significant role in the pathogenesis of metabolic syndrome and RH. This review aims to summarize recent studies on the role of the adipokines leptin, resistin, and adiponectin in the pathophysiology of RH and target-organ damage associated with this condition. The deregulation of adipokine levels has been associated with clinical characteristics frequently recognized in RH such as diabetes, hyperactivity of sympathetic and renin-angiotensin-aldosterone systems, and vascular and renal damage. Strategies to regulate adipokines may be promising for the management of RH and some clinical implications must be considered when managing controlled and uncontrolled patients with RH.