Transdiagnostic and sex differences in cognitive profiles of autism spectrum disorder and attention‐deficit/hyperactivity disorder

Abstract

An increasing number of studies have shown that autism spectrum disorder (ASD) and attention‐deficit/hyperactivity disorder (ADHD) share symptoms and aetiologies. However, transdiagnostic comparisons between ASD and ADHD is complicated due to the sex differences within each condition. To clarify the similarities and differences in the cognitive functioning between ASD and ADHD, while considering potential sex differences, this study compared cognitive profiles assessed by the WAIS‐III between the four groups created by orthogonally combining diagnosis and sex based on the data from 277 ASD males, 86 ASD females, 99 ADHD males and 64 ADHD females. The analysis revealed three major findings. First, performance IQ and perceptual organization index were higher in ADHD males than in ASD males and ADHD females. Second, Gaussian mixture model fitting revealed two clusters underlying the distribution of subindex scores. The percentage of being classified into the cluster that scored lower in all the subindices was higher in females than in males irrespective of diagnosis. Third, feature importance for classification of ASD and ADHD yielded by random forest classifier, a supervised machine learning algorithm, revealed that autism quotient was most informative feature in classifying ASD and ADHD in males, while the discrepancy between verbal and performance intelligence quotient was in females, indicating that the set of behavioral features contributing to classification differs between males and females. Thus, these findings indicate that sex as well as diagnosis is critical in determining the cognitive profiles of people with ASD and ADHD. Lay summary The present study compared profiles of cognitive functions measured by Wechsler Adult Intelligence Scale between males and females with ASD and ADHD. The analyses revealed clear sex differences in cognitive functions in both ASD and ADHD and that the set of cognitive functions useful in classifying ASD and ADHD differed between males and females. Thus, biological sex seems to be a critical factor in determining the cognitive profiles of people with ASD and ADHD.

Neurocognitive and cerebellar function in ADHD, autism and spinocerebellar ataxia

“…A previous study by Takeda et al (2020) attempted to identify differences in Wechsler Adult Intelligence Scale profiles between ADHD patients and healthy controls, but no significant group differences were found in Verbal intelligence quotient. However, a more recent study by Doi et al (2022) found that female ADHD patients had a lower Verbal intelligence quotient compared to males when characterizing the cognitive profile of ADHD and ASD.…”

“…Verbal intelligence quotient. However, a more recent study by Doi et al (2022) found that female ADHD patients had a lower Verbal intelligence quotient compared to males when characterizing the cognitive profile of ADHD and ASD.…”

Distinct neurocognitive profiles and clinical phenotypes associated with copy number variation at the 22q11.2 locus

“…Neurocognitive profiles are of clinical importance for individuals with neurodevelopmental disorders, as cognitive performance has been shown to relate to severity of communication and social difficulties (Demetriou et al, 2018; Leung et al, 2016; Oliveras‐Rentas et al, 2012) and repetitive behaviors (Mostert‐Kerckhoffs et al, 2015), can differentiate individuals with autism spectrum disorders (ASD) (Doi et al, 2022; Nader et al, 2015; Solomon et al, 2021), potentially predict behavioral challenges, and is often used to aid diagnoses (Nader et al, 2015). As such, classifying individuals based on neurocognitive profiles could provide a framework for uncovering genetic and neurobiological differences associated with autism phenotypes, allowing for improved diagnosis and clinical outcomes.…”

Distinct Neurocognitive Profiles and Clinical Phenotypes Associated with Copy Number Variation at the 22q11.2 Locus

“…Neurocognitive profiles are of clinical importance for individuals with neurodevelopmental disorders, as cognitive performance has been shown to relate to severity of communication and social difficulties (Demetriou et al, 2018;Leung, Vogan, Powell, Anagnostou, & Taylor, 2016;Oliveras-Rentas, Kenworthy, Roberson, Martin, & Wallace, 2012) and repetitive behaviors (Mostert-Kerckhoffs, Staal, Houben, & de Jonge, 2015), can differentiate individuals with Autism Spectrum Disorders (ASD) (Doi, Kanai, & Ohta, 2022;Nader, Jelenic, & Soulières, 2015;Solomon et al, 2021), potentially predict behavioral challenges, and is often used to aid diagnoses (Nader et al, 2015). As such, classifying individuals based on neurocognitive profiles could provide a framework for uncovering genetic and neurobiological differences associated with autism phenotypes, allowing for improved diagnosis and clinical outcomes.…”