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Attention deficit hyperactivity disorder and neurocognitive correlates after childhood stroke

Published online by Cambridge University Press:  27 August 2003

Jeffrey E. Max ,
Katherine Mathews ,
Facundo F. Manes ,
Brigitte A.M. Robertson ,
Peter T. Fox ,
Jack L. Lancaster ,
Amy E. Lansing ,
Amy Schatz  and
Nicole Collings
Jeffrey E. Max*
Affiliation:
University of California, San Diego and Children's Hospital and Health Center, San Diego, California
Katherine Mathews
Affiliation:
University of Iowa, Department of Pediatrics and Neurology, Iowa City, Iowa
Facundo F. Manes
Affiliation:
Raul Carrea Institute for Neurological Research—FLENI, Buenos Aires, Argentina
Brigitte A.M. Robertson
Affiliation:
GlaxoSmithKline, Research Triangle Park, North Carolina
Peter T. Fox
Affiliation:
Research Imaging Center, University of Texas Health Science Center, San Antonio, Texas
Jack L. Lancaster
Affiliation:
Research Imaging Center, University of Texas Health Science Center, San Antonio, Texas
Amy E. Lansing
Affiliation:
Children's Hospital and Health Center, Department of Psychiatry, San Diego, California
Amy Schatz
Affiliation:
Children's Hospital and Health Center, Department of Psychiatry, San Diego, California
Nicole Collings
Affiliation:
Children's Hospital and Health Center, Department of Psychiatry, San Diego, California
*
*Reprint requests to: Jeffrey E. Max, M.B.B.Ch, Children's Hospital and Health Center, San Diego, 3020 Children's Way, MC 5033, San Diego, CA 92123. E-mail: jmax@ucsd.edu
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Abstract

We investigated the frequency and neurocognitive correlates of attention deficit hyperactivity disorder and traits of this disorder (ADHD/Traits) after childhood stroke and orthopedic diagnosis in medical controls. Twenty-nine children with focal stroke lesions and individually matched children with clubfoot or scoliosis were studied with standardized psychiatric, intellectual, academic, adaptive, executive, and motivation function assessments. Lifetime ADHD/Traits were significantly more common in stroke participants with no prestroke ADHD than in orthopedic controls (16/28 vs. 7/29; Fisher's Exact p < .02). Lifetime ADHD/Traits in the orthopedic controls occurred exclusively in males with clubfoot (7/13; 54%). Participants with current ADHD/Traits functioned significantly worse (p < .005) than participants without current ADHD/Traits on all outcome measures. Within the stroke group, current ADHD/Traits was associated with significantly lower verbal IQ and arithmetic achievement (p < .04), more nonperseverative errors (p < .005), and lower motivation (p < .004). A principal components analysis of selected outcome variables significantly associated with current ADHD/Traits revealed “impaired neurocognition” and “inattention-apathy” factors. The latter factor was a more consistent predictor of current ADHD/Traits in regression analyses. These findings suggest that inattention and apathy are core features of ADHD/Traits after childhood stroke. This association may provide clues towards the understanding of mechanisms underlying the syndrome. (JINS, 2003, 9, 815–829.)

Keywords

ADHDChildhood strokeCognitionApathyClubfootScoliosis
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 9 , Issue 6 , September 2003 , pp. 815 - 829
Copyright
Copyright © The International Neuropsychological Society 2003

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References

Achenbach, T.M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington, Vermont: University of Vermont Department of Psychiatry.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association Press.Google Scholar
Andreasen, N.C., Endicott, J., Spitzer, R.L., & Winokur, G. (1977). The family history method using research diagnostic criteria: Reliability and validity. Archives of General Psychiatry, 34, 1229–1235.CrossRefGoogle ScholarPubMed
Barkley, R.A. (1997). ADHD and the nature of self-control. New York: The Guilford Press.Google Scholar
Bloom, D.R., Levin, H.S., Ewing-Cobbs, L., Saunders, A.E., Song, J., Fletcher, J.M., & Kowatch, R.A. (2001). Lifetime and novel psychiatric disorders after pediatric traumatic brain injury. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 572–579.CrossRefGoogle ScholarPubMed
Borkowski, J.G., Benton, A.L., & Spreen, O. (1967). Word fluency and brain damage. Neuropsychologia, 5, 135–140.CrossRefGoogle Scholar
Botting, N., Powls, A., & Cooke, R.W.I. (1997). Attention deficit hyperactivity disorders and other psychiatric outcomes in very low birthweight children at 12 years. Journal of Child Psychology and Psychiatry, 8, 931–941.CrossRefGoogle Scholar
Breslau, N. & Chilcoat, H.D. (2000). Psychiatric sequelae of low birth weight at 11 years of age. Biological Psychiatry, 47, 1005–1011.10.1016/S0006-3223(99)00312-1CrossRefGoogle ScholarPubMed
Costello, E.J., Angold, A., Burns, B.J., Erkanli, A., Stangl, D.K., & Tweed, D.L. (1996). The Great Smoky Mountains Study of Youth: Functional impairment and serious emotional disturbance. Archives of General Psychiatry, 53, 1137–1143.10.1001/archpsyc.1996.01830120077013CrossRefGoogle ScholarPubMed
Deutsch, C.K., Matthysse, S., Swanson, J.M., & Farkas, L.G. (1990). Genetic latent structure analysis of dysmorphology in attention deficit disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 189–194.10.1097/00004583-199003000-00006CrossRefGoogle ScholarPubMed
Ebaugh, F.G. (1923). Neuropsychiatric sequelae of acute epidemic encephalitis in children. American Journal of Diseases of Children, 25, 89–97.Google Scholar
Gerring, J.P., Freund, L., Gerson, A.C., Joshi, P.T., Capozzoli, J., Frosch, E., Brady, K., Marin, R.S., & Denckla, M.B. (1996). Psychometric characteristics of the Children's Motivation Scale. Psychiatry Research, 63, 205–217.CrossRefGoogle ScholarPubMed
Gerring, J.P., Brady, K.D., Chen, A., Vasa, R., Grados, M., Bandeen-Roche, K.J., Bryan, R.N., & Denckla, M.B. (1998). Premorbid prevalence of ADHD and development of secondary ADHD after closed head injury. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 647–654.CrossRefGoogle ScholarPubMed
Goodman, R. & Graham, P. (1996). Psychiatric problems in children with hemiplegia: Cross sectional epidemiological survey. British Medical Journal, 312, 1065–1069.CrossRefGoogle ScholarPubMed
Goodman, R. & Yude, C. (1996). IQ and its predictors in childhood hemiplegia. Developmental Medicine and Child Neurology, 38, 881–890.10.1111/j.1469-8749.1996.tb15045.xCrossRefGoogle ScholarPubMed
Goodman, R. & Yude, C. (1997). Do unilateral lesions of the developing brain have side-specific psychiatric consequences in childhood? Laterality, 2, 103–115.Google Scholar
Goodman, R.N. (1989). Neuronal misconnections and psychiatric disorder: Is there a link? British Journal of Psychiatry, 154, 292–299.CrossRefGoogle Scholar
Grant, D.A. & Berg, E.A. (1948). A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card sorting problem. Journal of General Psychology, 38, 404–411.CrossRefGoogle Scholar
Hollingshead, A.B. (1975). Four factor index of social status. New Haven, Connecticut: Yale University.Google Scholar
Ingram, T.T.S. (1956). A characteristic form of overactive behaviour in brain damaged children. Journal of Mental Science, 102, 550–558.CrossRefGoogle ScholarPubMed
Jastak, S. & Wilkerson, G.S. (1984). Wide Range Achievement Test: Administration manual. Wilmington, Delaware: Jastak Associates.Google Scholar
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., Williamson, D., & Ryan, N. (1997). Schedule for affective disorders and schizophrenia for school-age children—present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988.10.1097/00004583-199707000-00021CrossRefGoogle ScholarPubMed
Klorman, R., Hazel-Fernandez, L.A., Shaywitz, S.E., Fletcher, J.M., Marchione, K.E., Holahan, J.M., Stuebing, K.K., & Shaywitz, B.A. (1999). Executive functioning deficits in attention-deficit/hyperactivity disorder are independent of oppositional defiant or reading disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1148–1155.CrossRefGoogle ScholarPubMed
Lancaster, J.L., Glass, T.G., Lankipalli, B.R., Downs, H., Mayberg, H., & Fox, P.T. (1995). A modality-independent approach to spatial normalization. Human Brain Mapping, 3, 209–223.CrossRefGoogle Scholar
Levy, F., Hay, D.A., McStephen, M., Wood, C., & Waldman, I. (1997). Attention-deficit hyperactivity disorder: A category or a continuum? Genetic analysis of a large-scale twin study. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 737–744.CrossRefGoogle ScholarPubMed
Lou, H.C. (1996). Etiology and pathogenesis of attention-deficit hyperactivity disorder (ADHD): Significance of prematurity and perinatal hypoxic-haemodynamic encephalopathy. Acta Paediatrica, 85, 1266–1271.CrossRefGoogle ScholarPubMed
Marin, R.S., Fogel, B.S., Hawkins, J., Duffy, J., & Krupp, B. (1995). Apathy: A treatable syndrome. Journal of Neuropsychiatry and Clinical Neuroscience, 7, 23–30.Google ScholarPubMed
Max, J.E., Arndt, S., Castillo, C.S., Bokura, H., Robin, D.A., Lindgren, S.A., Smith, W.L. Jr., Sato, Y., & Mattheis, P.J. (1998a). Attention-deficit hyperactivity symptomatology after traumatic brain injury: A prospective study. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 841–847.CrossRefGoogle Scholar
Max, J.E., Castillo, C.S., Lindgren, S.D., & Arndt, S. (1998b). The neuropsychiatric rating schedule: Reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 297–304.10.1097/00004583-199803000-00015CrossRefGoogle Scholar
Max, J.E., Fox, P.T., Lancaster, J.L., Kochunov, P., Mathews, K., Manes, F.F., Robertson, B.A.M., Arndt, S., Robin, D.A., & Lansing, A.E. (2002). Putamen lesions and the development of attention-deficit/hyperactivity symptomatology. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 563–571.CrossRefGoogle ScholarPubMed
Max, J.E., Mathews, K., Lansing, A., Robertson, B.A.M., Fox, P., Lancaster, J., Manes, F.F., & Smith, J. (2002). Psychiatric disorders after childhood stroke. Journal of American Academy of Child and Adolescent Psychiatry, 41, 555–562.10.1097/00004583-200205000-00013CrossRefGoogle ScholarPubMed
Max, J.E., Lansing, A.E., Koele, S.L., Castillo, C.S., Bokura, H., Schachar, R., Collings, N., & Williams, K.E. Attention deficit hyperactivity disorder in children and adolescents following traumatic brain injury. Developmental Neuropsychology (in press).Google Scholar
Miller, I.W., Kabacoff, R.I., Epstein, N.B., & Bishop, D.S. (1994). The development of a clinical rating scale for the McMaster model of family functioning. Family Process, 33, 53–69.CrossRefGoogle ScholarPubMed
Nussbaum, N.L., Grant, M.L., Roman, M.J., Poole, J.H., & Bigler, E.D. (1990). Attention deficit disorder and the mediating effect of age on academic and behavioral variables. Journal of Developmental and Behavioral Pediatrics, 11, 22–26.CrossRefGoogle ScholarPubMed
Ounsted, C. (1955). The hyperkinetic syndrome in epileptic children. Lancet, 2, 303–311.CrossRefGoogle Scholar
Pennington, B.F. & Ozonoff, S. (1996). Executive function and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37, 51–87.CrossRefGoogle Scholar
Posner, M.I. & Petersen, S.E. (1990). The attention system of the human brain. Annual Reviews of Neuroscience, 13, 25–42.10.1146/annurev.ne.13.030190.000325CrossRefGoogle ScholarPubMed
Riva, D. & Cazzaniga, L. (1986). Late effects of unilateral brain lesions sustained before and after age one. Neuropsychologia, 24, 423–428.10.1016/0028-3932(86)90029-1CrossRefGoogle ScholarPubMed
Roach, E.S. & Riela, A.R. (1995). Inflammatory vascular disorders. In Roach, E.S. and Riela, A.R. (Eds.), Pediatric Cerebrovascular Disorders (2nd ed., pp. 121–139). Armonk, New York: Futura Publishing Company, Inc.Google Scholar
Rutter, M., Graham, P., & Yule, W. (1970). A neuropsychiatric study in childhood. Clinics in Developmental Medicine, Nos. 35/36. London, UK: Heinemann/Spastics International Medical Publications.Google Scholar
Seidel, U.P., Chadwick, O.F., & Rutter, M. (1975). Psychological disorders in crippled children. A comparative study of children with and without brain damage. Developmental Medicine and Child Neurology, 17, 563–573.10.1111/j.1469-8749.1975.tb03522.xCrossRefGoogle ScholarPubMed
Shaywitz, B.A. & Shaywitz, S.E. (1994). Learning disabilities and attention disorders. In Swaiman, K. (Ed.), Principles of pediatric neurology (pp. 1119–1151). St. Louis, Missouri: Mosby.Google Scholar
Shelton, T.L., Barkley, R.A., Crosswait, C., Moorehouse, M., Fletcher, K., Barrett, S., Jenkins, L., & Metevia, L. (1998). Psychiatric and psychological morbidity as a function of adaptive disability in preschool children with aggressive and hyperactive-impulsive-inattentive behavior. Journal of Abnormal Child Psychology, 26, 475–494.CrossRefGoogle ScholarPubMed
Sparrow, S.S., Balla, D., & Cicchetti, D. (1984). The Vineland Adaptive Behavior Scales. Circle Pines, Minnesota: American Guidance Services.Google Scholar
Wechsler, D. (1991). Wechsler Intelligence Scale for Children–Third Edition. New York: Psychological Corporation.Google Scholar
Whitaker, A.H., Van Rossem, R., Feldman, J.F., Schonfeld, I.S., Pinto-Martin, J.A., Torre, C., Shaffer, D., & Paneth, N. (1997). Psychiatric outcomes in low-birth-weight children at age 6 years: Relation to neonatal cranial ultrasound abnormalities. Archives of General Psychiatry, 54, 847–856.CrossRefGoogle ScholarPubMed
Willcutt, E.G. & Pennington, B.F. (2000). Comorbidity of reading disability and attention-deficit/hyperactivity disorder: Differences by gender and subtype. Journal of Learning Disabilities, 33, 179–191.CrossRefGoogle ScholarPubMed
Wood, F.B. & Felton, R.H. (1994). Separate linguistic and attentional factors in the development of reading. Topics in Language Disorders, 14, 42–57.CrossRefGoogle Scholar
Woods, B.T. (1980). The restricted effects of right-hemisphere lesions after age one: Wechsler test data. Neuropsychologia, 18, 65–70.10.1016/0028-3932(80)90084-6CrossRefGoogle ScholarPubMed