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Journal Article 2016; 37(4): 289-294 PubMed PMID: 27857045 Citation  Keywords:  Adolescent, Adrenergic Uptake Inhibitors:therapeutic use, Atomoxetine Hydrochloride:therapeutic use, Attention Deficit Disorder with Hyperactivity:diagnostic imaging, Brain:diagnostic imaging, Central Nervous System Stimulants:therapeutic use, Dopamine Pl.   

OBJECTIVES: ADHD is one of the most significant diagnostic units in child and adolescent psychiatry. The occurrence in children is 5-6% and 50-80% continued to adult age. The presence of individual genes (polymorphism) on particular symptoms and processes in ADHD are not known. It is estimated that ADHD symptoms are up to 80% to genetic. The higher density of resultant DAT 1 protein was observed in ADHD patients in comparison with controls. The question was if DAT 1 10/10 predicted bad prognoses in long term therapy.

METHODS: We compared 30 ADHD DAT 1 10/10 adolescents treated for 5-6 years. Patients with 30 control adolescents. They were the same age of probands and controls. All these subjects were examined by child psychiatry scales (Conners, Achenbach…). Biological changes were tested by MRI specific CNS volumometry.

RESULTS: We didn't confirm bad prognoses in long term therapy with methylphenidate or atomoxetine in ADHD children DAT 1 10/10 in long term therapy. In MRI specific CNS volumometry were not identify any differences in controls and ADHD probands. Gray matter thickness was significantly higher in prefrontal and occipital areas in patients compared to control in prefrontal and occipital areas with cluster-wise p-value<0.05. By this method were not identify any cerebrum damage in long term therapy by methylphenidate and atomoxetine....

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Journal Article 2016; 37(1): 29-32 PubMed PMID: 26994382 Citation  Keywords:  Adolescent, Attention Deficit Disorder with Hyperactivity:drug therapy, Basal Ganglia:abnormalities, Brain:abnormalities, Central Nervous System Stimulants:therapeutic use, Child, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging, Male, .   

: We discussed the cross section studies and the meta-analysis of published data in children and adolescents with ADHD (both drug naive and receiving stimulant medications), in comparison with healthy children and adolescents of the same age. In children and adolescents with ADHD the deceleration of the maturation dynamics of discrete CNS structures is found, volume reduction and decreased grey matter in prefrontal and occipital regions, which is accompanied by reverse asymmetry of the basal ganglia volume (putamen, nucleus caudate). The above mentioned developmental characteristics are valid only for the ADHD children, who have not been treated by stimulant medications. The stimulant treatment eliminates the mentioned changes into various extend. These developmental changes of CNS structures volume are missing in girls....

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Journal Article 2014; 35(1): 1-6 PubMed PMID: 24625909 Citation  Keywords:  Attention Deficit Disorder with Hyperactivity:complications, Central Nervous System Stimulants:adverse effects, Child, Child Development:drug effects, Growth:drug effects, Humans,.   

: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed childhood psychiatric disorders. It is manifested in every part of an affected child's behavior, with multiple symptomatology and heterogenous etiology. Published studies report that ADHD children may show changes in growth and development. Most of the studies on ADHD have been focused on connections between medication and growth changes and describe growth delays associated with medication. However, recent research results point to the low significance of the changes accompanying pharmacological treatment. Changes in growth may not only be a secondary effect of the treatment, but may also be specific characteristics of ADHD....

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Journal Article 2012; 33(2): 201-206 PubMed PMID: 22592202 Citation  Keywords:  Adult, Attention Deficit Disorder with Hyperactivity:diagnosis, Case-Control Studies, Child, Female, Humans, Male, Parents:psychology, Prospective Studies, Psychiatric Status Rating Scales:statistics & numerical data,.   

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is one of the most common mental health disorders in childhood; symptoms persist into adulthood in a majority of patients. It is among the most heritable of psychiatric disorders with a high risk for familial aggregation and has been linked in adulthood with impairment across a variety of domains, including parenting. Parental gender, ADHD status and symptom expression could be related to the severity of ADHD symptoms in the child.

METHODS: We used prospective, observational study of clinical group of 30 children with diagnosed ADHD and control group of 37 healthy subjects. Only children with both biological parents available were included. Data on ADHD symptomatology for all subjects was gathered by a set of clinical tools (CBCL1991, TRF1991, WURS, self-report scale modified from DSM IV). Under the assumption that ADHD is a dimensional disorder, raw scores from questionnaires were used as they display the complete range of values.

RESULTS: Clinical group showed higher values in all areas of children symptomatology, the same was observed for parental ADHD symptomatology. Significant correlation was found between children and paternal current ADHD symptomatology in the clinical group. This was not confirmed for mothers.

CONCLUSION: Our study stresses an importance of screening for ADHD symptoms in parents of clinically referred children with ADHD as the correlation between severity of paternal and child's ADHD symptoms was confirmed. Our results stress the importance of including the father into the clinical assessment....

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Journal Article 2011; 32(6): 790-798 PubMed PMID: 22286786 Citation  Keywords:  Anxiety Disorders:metabolism, Attention Deficit Disorder with Hyperactivity:metabolism, Child, Circadian Rhythm:physiology, Humans, Melatonin:metabolism, Saliva:chemistry,.   

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders are the most frequent psychiatric disorders in children. Changes in rhythms of symptoms during the day may be influenced by genetic, biological and psychological factors. Some changes of melatonin rhythm may hypothetically change the activity of ADHD by changing arousal or in anxiety children by changing their emotional state. In our present study we identify one group of ADHD children combine type without comorbids, one group of anxiety children and a control group. Most changes of melatonin daily rhythm are supposed in the anxiety group, especially in sleeping time, and more prominent change in the ADHD group with prominent hyperactivity and conduct disorder symptoms.

METHODS: Thirty-four ADHD and forty-three control children and eleven anxiety children, all 6-12 years old, participated in the study. The saliva specimens were collected in four different sessions during the school year, around the time of the spring and autumn equinox, when the natural light lasted 11.2 h ± 0.9 h.

RESULTS AND CONCLUSIONS: In our study more symptoms of conduct disorder elevated positive or negative correlations between psychopathology and saliva level of melatonin in ADHD and anxiety samples. We hypothesize that co-morbidity of ADHD or anxiety with impulsivity and conduct disorders might have elevated correlations between psychopathology of ADHD or anxiety and plasma melatonin level....

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Case Reports 2011; 32(5): 619-622 PubMed PMID: 22167138 Citation  Keywords:  Administration, Oral, Attention Deficit and Disruptive Behavior Disorders:complications, Central Nervous System Stimulants:administration & dosage, Child, Female, Hallucinations:chemically induced, Humans, Methylphenidate:administration & dosage, Sleep De.   

: We report a case of a girl with Attention deficit hyperactivity disorder (ADHD) and Oppositional defiant disorder (ODD) who experienced a 3-hour episode of nocturnal complex bizarre visual hallucinations when treated with 18 mg Osmotic Release Oral System (OROS) methylphenidate (MPH). Nocturnal polysomnography performed two weeks later revealed REM sleep reduction (17%) and fragmentation . Two episodes of confusional arousals were recorded. This finding is typical of parasomnia associated with NREM sleep - disorder of arousal. We hypothesize that this preexisting sleep impairment represents a factor of vulnerability to MPH sleep side effects. In our search of literature, we found no report of nocturnal hallucination alone during treatment with stimulants....

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Journal Article 2011; 32(4): 481-486 PubMed PMID: 21876488 Citation  Keywords:  Adult, Attention:physiology, Cognition:physiology, Female, Humans, Male, Memory, Short-Term:physiology, Motor Cortex:physiology, Photic Stimulation:methods, Psychomotor Performance:physiology, Theta Rhythm:physiology, Time Perception:physiology, Transcran.   

OBJECTIVES: Supplementary motor area (SMA) was suggested to have a dominant role in the temporal control of behavior by many neuroimaging studies. The aim of this study was to support this hypothesis by influencing time estimates with theta burst transcranial magnetic stimulation (TMS) over the SMA.

METHODS: Nineteen healthy volunteers with a mean age 25.9±3 (SD) years performed the time reproduction task (TRT) before and after 190 seconds of intermittent theta-burst TMS over SMA and the precuneus (total 600 pulses). The TRT consisted of an encoding phase (during which visual stimuli with durations of 5, 10 and 16.82 seconds were presented pseudorandomly) and a reproduction phase (during which interval durations were reproduced by pressing a button). Mean subjects' interval estimates as a measure of accuracy and standard deviation as a measure of variability pre-TMS and post-TMS were compared.

RESULTS: Theta-burst TMS over both areas had no effect on the accuracy of duration estimates. An increased variability of interval reproduction was present after stimulation of the precuneus (p<0.01) with the biggest effect on the five second interval. Stimulation of SMA caused a decrease of variability in the ten second interval only (p<0.05).

CONCLUSION: It is likely that increased variability of time estimates is a non-specific result of impaired attention and working memory after theta-burst TMS. Decreased variability after stimulation over the SMA could be explained in terms of enhanced activity of the physiological oscillator with a frequency close to 0.1 Hz....

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Journal Article 2011; 32(3): 354-359 PubMed PMID: 21712788 Citation  Keywords:  Adult, Age of Onset, Attention:physiology, Cognition:physiology, Cognition Disorders:etiology, Executive Function, Female, Humans, Learning:physiology, Male, Memory:physiology, Middle Aged, Neuropsychological Tests, Psychomotor Performance:physiology, Spi.   

OBJECTIVES: Cognitive disorders and dementia occur in 19 to 42% of patients with spinocerebellar ataxia type 2 (SCA2). Neuropsychological tests can reveal executive dysfunction, impaired visual and verbal memory, tongue and speech impairment, attention disorders and impaired verbal fluency.

METHODS: We performed psychiatric and neuropsychological examinations in 12 patients diagnosed with genetically confirmed SCA2 and 12 healthy volunteers matching the patients in age, gender, and length of education. The level of motor impairment was determined using the brief ataxia rating scale (BARS). The neuropsychological examination focused on testing executive functions, short-term visual and verbal memory, attention, psychomotor tempo, visual motor coordination, learning ability and comprehension ability. The tests were divided into two subgroups according to the difficulty of motor tasks. The cognitive abilities composite score (CACS) was determined by calculating the arithmetic mean of T scores of the respective tests.

RESULTS: Patients with SCA2 had significantly lower CACSs (p=0.00005) compared to the healthy volunteers. Patients exhibited impaired performance in both difficult and simple motor tests. The severity of cognitive impairment was related to the age at the onset of the disease (p=0.002) but not to the duration or to the overall BARS score.

CONCLUSIONS: Compared to healthy volunteers, patients with SCA2 exhibited significantly worse cognitive performance in all areas tested, including the tests of simple motor tasks. Moreover, the cognitive performance of patients worsened as the difficulty of the motor tasks increased....

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