Impaired cortical inhibition in adult ADHD patients: a study with transcranial magnetic stimulation*

Schneider, Marc; Retz, Wolfgang; Freitag, Christine M.; Irsch, J.; Graf, Peter; Retz-Junginger, Petra; Rosier, Marius

doi:10.1007/978-3-211-73574-9_37

Cited by 22 publications

(15 citation statements)

References 51 publications

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“…The findings are similar to those from a recent study by our research group investigating intracortical inhibition in a sample of adult ADHD patients [19] . In line with a preliminary report on adults with ADHD [27] , we found a significant reduction of intracortical inhibition but no significant increase in cortical facilitation in the ADHD sample.…”

Section: Discussionsupporting

confidence: 82%

“…Decreased motor inhibition has been shown to be correlated with a variety of behavioural dysfunctions such as impulsivity in attention deficit/hyperactivity disorder (ADHD) patients [19] and other neuropsychiatric disorders including epilepsy, dystonia and Parkinson's disease. On a different level of investigation within the neurobiological domain, we propose that differences in inhibitory control can be found between people with and people without a history of violence.…”

Section: Introductionmentioning

confidence: 99%

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Reduced Cortical Inhibition in Violent Offenders: A Study with Transcranial Magnetic Stimulation

Philipp-Wiegmann

Rösler²,

Römer³

et al. 2011

Neuropsychobiology

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Background: Aggression and violent behaviour are often regarded as a threat to society. Therefore, understanding violent behaviour has high social relevance. We performed a study with transcranial magnetic stimulation on a sample of violent offenders in order to measure cortical inhibition in the motor neuron system that is part of the frontal cortex. Methods: To investigate intracortical inhibition and intracortical facilitation, we conducted paired-pulse stimulation according to the technique of Kujirai and his group (see Method). The investigation sample comprised 62 right-handers: 32 prisoners who had committed severe violent crimes and 30 controls with no history of violence. All subjects were male and matched for age. Results: Using the paired-pulse paradigm with interstimulus intervals (ISI) of 1–15 ms, a reduced cortical inhibition (ISI: 3 ms) was found in the left cortex of violent offenders compared with control subjects. Conclusions: These findings corroborate the hypothesis of inhibition deficits and frontal cortex dysfunction in violent offenders when compared with non-violent control subjects.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Reduced Cortical Inhibition in Violent Offenders: A Study with Transcranial Magnetic Stimulation

Philipp-Wiegmann

Rösler²,

Römer³

et al. 2011

Neuropsychobiology

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“…The situation for ADHD is more clearly laid out. Two studies revealed a reduced SICI in adult ADHD patients [12,25], whereas in another study this could not reach statistical significance [26]. In contrast to schizophrenia patients, ADHD patients did not show a prolonged CSP compared to HC in previous studies [27].…”

Section: Discussionmentioning

confidence: 92%

“…Twenty-eight patients with ADHD and 25 patients with FE-SZ (all paranoid subtype) from the same geographical area were recruited from inpatient and outpatient units and were compared with 41 healthy subjects. Parts of the sample have previously been published independently [11,21,25], but this study provides new data on direct comparison of disorders, CSP in ADHD and late-ICF in FE-SZ. Subjects with a history of dementia, neurological illnesses and severe brain injuries were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, a reduced duration of the CSP and the ipsilateral silent period, a measure of interhemispheric connectivity, is a common finding in children with ADHD [23,24]. In adults with ADHD, two studies revealed a reduced SICI [12,25] and in another study the reduced SICI did not reach statistical significance [26]. Methodological differences in measuring and analyzing cortical excitability in adults with ADHD might be related to the negative finding of the latter study.…”

Section: Introductionmentioning

confidence: 99%

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A Similar but Distinctive Pattern of Impaired Cortical Excitability in First-Episode Schizophrenia and ADHD

et al. 2013

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Background: First-episode schizophrenia (FE-SZ) and attention deficit hyperactivity disorder (ADHD) are both neuropsychiatric disorders associated with an impaired dopaminergic transmission. Though displaying different clinical phenotypes, a common pathophysiological pathway is discussed controversially. Several studies using transcranial magnetic stimulation (TMS) revealed abnormalities in human motor cortex excitability in both schizophrenia and ADHD patients. Studies on cortical excitability comparing these two diseases directly are lacking. Method: In this study, a total of 94 subjects were analyzed. Twenty-five FE-SZ patients were directly compared with 28 ADHD patients and 41 healthy controls (HC). We investigated cortical excitability (inhibitory and facilitatory networks) with single- and paired-pulse TMS to the left and right motor cortex. Results: Compared to HC, FE-SZ/ADHD patients displayed an impaired cortical inhibition over the left hemisphere. Apart from an enhanced intracortical facilitation, FE-SZ patients did not differ compared to ADHD patients in the main outcome measures. Both patient groups presented a dysfunctional hemispheric pattern of cortical inhibition and facilitation in comparison with HC. Conclusion: The results of this study indicate a pattern of cortical disinhibition and abnormal hemispheric balance of intracortical excitability networks in two different psychiatric diseases. These effects might be associated with an imbalance in GABAergic and dopaminergic transmission and might provide evidence for a common pathophysiological pathway of both diseases.

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ADHS-Diagnose bei Erwachsenen

et al. 2008

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We report on a study comparing different systems for the diagnosis of attention deficit hyperactivity disorder (ADHD) in adulthood. Recruited for evaluation were 168 patients referred to our ADHD outpatient unit. We used the Diagnostic and Statistical Manual of Mental Disorders 4th edn. (DSM-IV), International Classification of Diseases 10th edn. (ICD-10), and Utah criteria for diagnostic assessment and the Wender Utah rating scale, ADHD Self Report (ADHD-SR), and Wender Reimherr Adult Attention Deficit Disorder Rating Scale as psychopathological assessment tools. We present basic psychometric data of the Wender-Reimherr Interview (WRI). Internal consistency was determined as 0.82 (alpha). The inter-rater reliability was 1.0 (kappa coefficient) regarding ADHD diagnoses, and the ICC was 0.98 referring to the WRI total scores. The convergent validity with the ADHD-SR was 0.65 (Spearman coefficient). In 126 of 168 patients an ADHD diagnosis was made according to at least one of the three systems. The DSM-IV diagnostic set led to 119 ADHD diagnoses. As compared with the two other systems, this is about the minimum level for an ADHD diagnosis. All of the 87 ADHD diagnoses according to ICD-10 were covered by DSM-IV. The ICD-10 had no independent psychopathological items and therefore offered no additional points for the diagnostic procedure than the DSM-IV. The situation regarding Utah criteria is different. These criteria contain seven psychopathological domains: inattention, hyperactivity, disorganisation, impulsivity, affective lability, overreactivity, and hot temper. They can be assessed by use of the WRI. Ninety-three of 168 patients were diagnosed as having ADHD according to the Utah concept, which is much lower than with the DSM-IV. The particular definition of the disorder by the Utah criteria resulted in seven patients having only a Utah diagnosis but no DSM-IV diagnosis. Thus we are in a position to say that the Utah criteria have a relatively high level for making an ADHD diagnosis but in certain cases move beyond the DSM-IV. Of the patients 56% had ADHD diagnoses according to all three classification instruments. Examining the factor structure of the ADHD psychopathology represented by seven WRI and three ADHD-SR subscales, we found a two-factor solution explaining for 63% of the variance. Factor 1 was designated by impulsivity, affective lability, hyperactivity, and hot temper; factor 2 consisted of inattention, disorganisation, and overreactivity.

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Impaired cortical inhibition in adult ADHD patients: a study with transcranial magnetic stimulation*

Cited by 22 publications

References 51 publications

Reduced Cortical Inhibition in Violent Offenders: A Study with Transcranial Magnetic Stimulation

Reduced Cortical Inhibition in Violent Offenders: A Study with Transcranial Magnetic Stimulation

A Similar but Distinctive Pattern of Impaired Cortical Excitability in First-Episode Schizophrenia and ADHD

ADHS-Diagnose bei Erwachsenen

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