Vigilance, Inhibitory Control and Regional Cerebral Blood Oxygenation in the PFC - Differences in ADHD Types of Presentations

Skalski, Sebastian; Dobrakowski, Paweł

doi:10.5709/acp-0297-5

Cited by 9 publications

(5 citation statements)

References 54 publications

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“…Decreased frontal lobe perfusion is a consistent finding in ADHD across multiple SPECT studies ( 327 , 338 – 345 ) and confirmed by multiple functional MRI studies ( 346 , 347 ) and infrared spectroscopy ( 348 ). For example, SPECT scans of medication-naïve children with ADHD ( N = 40) were compared to normal controls using statistical parametric analysis ( 338 ).…”

Section: Assessment Of the State Of The Art—spect In Brain Disordersmentioning

confidence: 61%

The Legacy of the TTASAAN Report—Premature Conclusions and Forgotten Promises: A Review of Policy and Practice Part I

2022

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Brain perfusion single photon emission computed tomography (SPECT) scans were initially developed in 1970's. A key radiopharmaceutical, hexamethylpropyleneamine oxime (HMPAO), was originally approved in 1988, but was unstable. As a result, the quality of SPECT images varied greatly based on technique until 1993, when a method of stabilizing HMPAO was developed. In addition, most SPECT perfusion studies pre-1996 were performed on single-head gamma cameras. In 1996, the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology (TTASAAN) issued a report regarding the use of SPECT in the evaluation of neurological disorders. Although the TTASAAN report was published in January 1996, it was approved for publication in October 1994. Consequently, the reported brain SPECT studies relied upon to derive the conclusions of the TTASAAN report largely pre-date the introduction of stabilized HMPAO. While only 12% of the studies on traumatic brain injury (TBI) in the TTASAAN report utilized stable tracers and multi-head cameras, 69 subsequent studies with more than 23,000 subjects describe the utility of perfusion SPECT scans in the evaluation of TBI. Similarly, dementia SPECT imaging has improved. Modern SPECT utilizing multi-headed gamma cameras and quantitative analysis has a sensitivity of 86% and a specificity of 89% for the diagnosis of mild to moderate Alzheimer's disease—comparable to fluorodeoxyglucose positron emission tomography. Advances also have occurred in seizure neuroimaging. Lastly, developments in SPECT imaging of neurotoxicity and neuropsychiatric disorders have been striking. At the 25-year anniversary of the publication of the TTASAAN report, it is time to re-examine the utility of perfusion SPECT brain imaging. Herein, we review studies cited by the TTASAAN report vs. current brain SPECT imaging research literature for the major indications addressed in the report, as well as for emerging indications. In Part II, we elaborate technical aspects of SPECT neuroimaging and discuss scan interpretation for the clinician.

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Section: Assessment Of the State Of The Art—spect In Brain Disordersmentioning

confidence: 61%

The Legacy of the TTASAAN Report—Premature Conclusions and Forgotten Promises: A Review of Policy and Practice Part I

2022

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“…Specifically, sleep deprivation attenuates activation of various parietal and frontal cortical regions, including the prefrontal cortex 44 , 45 , which plays a central role in sustained attention. Notably, ADHD is associated with lower activation in the prefrontal cortex during tasks that involve attention 46 and inhibitory control tasks 47 . Thus, sleep deprivation may aggravate the deficits in the functioning of the prefrontal cortex and related regions, leading to a more severe disruption in the performance of tasks that require sustained attention.…”

Section: Discussionmentioning

confidence: 99%

The effects of sleep deprivation on the processing of emotional facial expressions in young adults with and without ADHD

Cohen

Asraf

Saveliev

et al. 2021

Sci Rep

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The ability to recognize emotions from facial expressions is essential to the development of complex social cognition behaviors, and impairments in this ability are associated with poor social competence. This study aimed to examine the effects of sleep deprivation on the processing of emotional facial expressions and nonfacial stimuli in young adults with and without attention-deficit/hyperactivity disorder (ADHD). Thirty-five men (mean age 25.4) with (n = 19) and without (n = 16) ADHD participated in the study. During the five days preceding the experimental session, the participants were required to sleep at least seven hours per night (23:00/24:00–7:00/9:00) and their sleep was monitored via actigraphy. On the morning of the experimental session, the participants completed a 4-stimulus visual oddball task combining facial and nonfacial stimuli, and repeated it after 25 h of sustained wakefulness. At baseline, both study groups had poorer performance in response to facial rather than non-facial target stimuli on all indices of the oddball task, with no differences between the groups. Following sleep deprivation, rates of omission errors, commission errors and reaction time variability increased significantly in the ADHD group but not in the control group. Time and target type (face/non-face) did not have an interactive effect on any indices of the oddball task. Young adults with ADHD are more sensitive to the negative effects of sleep deprivation on attentional processes, including those related to the processing of emotional facial expressions. As poor sleep and excessive daytime sleepiness are common in individuals with ADHD, it is feasible that poor sleep quality and quantity play an important role in cognitive functioning deficits, including the processing of emotional facial expressions that are associated with ADHD.

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“…Recently, these neuroimaging findings have been replicated using a newer technique of infrared spectroscopy ( 72 ). A sample of 150 children with ADHD were compared to 51 controls in a series of concentration tasks.…”

Section: Discussionmentioning

confidence: 99%

SPECT Functional Neuroimaging Distinguishes Adult Attention Deficit Hyperactivity Disorder From Healthy Controls in Big Data Imaging Cohorts

2021

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Background: The diagnosis of attention deficit hyperactivity disorder (ADHD) relies on history and observation, as no reliable biomarkers have been identified. In this study, we compared a large single diagnosis group of patients with ADHD (combined, inattentive, and hyperactive) to healthy controls using brain perfusion single-photon emission computed tomography (SPECT) imaging to determine specific brain regions which could serve as potential biomarkers to reliably distinguish ADHD.Methods: In a retrospective analysis, subjects (n = 1,135) were obtained from a large multisite psychiatric database, where resting state (baseline) and on-task SPECT scans were obtained. Only baseline scans were analyzed in the present study. Subjects were separated into two groups – Group 1 (n = 1,006) was composed of patients who only met criteria for ADHD with no comorbid diagnoses, while a control group (n = 129) composed of individuals who did not meet criteria for any psychiatric diagnosis, brain injury, or substance use served as a non-matched control. SPECT regions of interests (ROIs) and visual readings were analyzed using binary logistic regression. Predicted probabilities from this analysis were inputted into a Receiver Operating Characteristic analysis to identify sensitivity, specificity, and accuracy.Results: The baseline ROIs and visual readings show significant separations from healthy controls. Sensitivity of the visual reads was 100% while specificity was >97%. The sensitivity and specificity of the post-hoc ROI analysis were both 100%. Decreased perfusion was primarily seen in the orbitofrontal cortices, anterior cingulate gyri, areas of the prefrontal cortices, basal ganglia, and temporal lobes. In addition, ROI analysis revealed some unexpected areas with predictive value in distinguishing ADHD, such as cerebellar subregions and portions of the temporal lobes.Conclusions: Brain perfusion SPECT distinguishes adult ADHD patients without comorbidities from healthy controls. Areas which were highly significantly different from control and thus may serve as biomarkers in baseline SPECT scans included: medial anterior prefrontal cortex, left anterior temporal lobe, and right insular cortex. Future studies of these potential biomarkers in ADHD patients with comorbidities are warranted.

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Vigilance, Inhibitory Control and Regional Cerebral Blood Oxygenation in the PFC - Differences in ADHD Types of Presentations

Cited by 9 publications

References 54 publications

The Legacy of the TTASAAN Report—Premature Conclusions and Forgotten Promises: A Review of Policy and Practice Part I

The Legacy of the TTASAAN Report—Premature Conclusions and Forgotten Promises: A Review of Policy and Practice Part I

The effects of sleep deprivation on the processing of emotional facial expressions in young adults with and without ADHD

SPECT Functional Neuroimaging Distinguishes Adult Attention Deficit Hyperactivity Disorder From Healthy Controls in Big Data Imaging Cohorts

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