Central nervous system processing of emotions in children with nocturnal enuresis and attention-deficit/hyperactivity disorder

This study compares the efficacy and tolerability of central nervous system (CNS) stimulants in children with attention deficit hyperactivity disorder (ADHD) with and without prominent irritability (IRR) over the course of 30 months. This is a secondary analysis of a study examining growth patterns in medication naïve children with ADHD subsequently treated with CNS stimulants (predominantly OROS-Methylphenidate, up to 54 mg per day) for 30 months. Participants had to meet full diagnostic criteria for ADHD and been treated with CNS stimulants for under 30 days. Children were classified as IRR if they were rated as pretty much or very much on either of the “often angry” or easily annoyed” items plus “lose temper,” items of the Disruptive Behavior Disorders Rating Scale (DBDRS). Structured ratings of ADHD symptoms, impairment, side effects, and symptoms of oppositional defiant disorder (ODD) were collected every 2–12 weeks for the duration of the study. Medication use was measured by pill count and parent report. The IRR group comprised 28% of all participants. The IRR group had significantly higher levels of ADHD and ODD symptoms, impairment, and side effects ratings at baseline. In the IRR group, ODD symptoms, emotional lability, and impairment significantly decreased for participants with higher medication use. Total side effects increased for non-IRR participants with higher medication use. Emotional side effects decreased for IRR participants with higher medication use. Central nervous system stimulants were a tolerable and efficacious treatment in treatment naïve youth with ADHD with irritability.Clinical Trials Registration: NCT01109849

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An Investigation of Stimulant Effects on the EEG of Children With Attention-Deficit/Hyperactivity Disorder

Clinical EEG and Neuroscience ◽

10.1177/1550059416664657 ◽

2016 ◽

Vol 48 (4) ◽

pp. 235-242 ◽

Cited By ~ 5

Author(s):

Adam R. Clarke ◽

Robert J. Barry ◽

Iris E. Baker ◽

Rory McCarthy ◽

Mark Selikowitz

Keyword(s):

Central Nervous System ◽

Attention Deficit Hyperactivity Disorder ◽

Nervous System ◽

Attention Deficit ◽

Total Power ◽

Control Group ◽

Hyperactivity Disorder ◽

Eyes Closed ◽

Eeg Abnormalities ◽

Stimulant Medications

Stimulant medications are the most commonly prescribed treatment for Attention-Deficit/Hyperactivity Disorder (AD/HD). These medications result in a normalization of the EEG. However, past research has found that complete normalization of the EEG is not always achieved. One reason for this may be that studies have used different medications interchangeably, or groups of subjects on different stimulants. This study investigated whether methylphenidate and dexamphetamine produce different levels of normalization of the EEG in children with AD/HD. Three groups of 20 boys participated in this study. There were 2 groups with a diagnosis of AD/HD; one group, good responders to methylphenidate, and the second, good responders to dexamphetamine. The third group was a normal control group. Baseline EEGs were recorded using an eyes-closed resting condition, and analyzed for total power and relative delta, theta, alpha, and beta. Subjects were placed on a 6-month trial of methylphenidate or dexamphetamine, after which a second EEG was recorded. At baseline, the children with AD/HD had elevated relative theta, less relative alpha and beta compared with controls. Baseline differences were found between the two medication groups, with the dexamphetamine group having greater EEG abnormalities than the methylphenidate group. The results indicate that good responders to methylphenidate and dexamphetamine have different EEG profiles when assessed before medication, and these differences may represent different underlying central nervous system deficits. The 2 medications were found to result in substantial normalization of the EEG, with no significant differences in EEG changes occurring between the 2 medications. This indicates that the degree of pretreatment EEG abnormality was the major factor contributing to the degree of normalization of the EEG. As good responders to the 2 medications appear to have different central nervous system abnormalities, it is recommended that stimulant medications be treated independently and not used interchangeably in research and treatment of AD/HD.

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Neuropsychiatry of nutritional disorders

Oxford Textbook of Neuropsychiatry ◽

10.1093/med/9780198757139.003.0033 ◽

2020 ◽

pp. 401-410

Author(s):

Nick Medford

Keyword(s):

Central Nervous System ◽

Attention Deficit Hyperactivity Disorder ◽

Nervous System ◽

Global Health ◽

Attention Deficit ◽

Neurodevelopmental Disorders ◽

Nutritional Deficiencies ◽

Hyperactivity Disorder ◽

Global Health Issue ◽

The Relationship

Malnutrition is a hugely extensive global health issue, with an estimated 800 million affected worldwide and almost 2 billion when those with specific nutritional deficiencies are taken into account. This chapter discusses the link between nutritional deficiency and neuropsychiatric disorder. In some cases, this can take the form of a clear cause and effect such as the prevalence of Wernicke’s encephalopathy in those with thiamine deficiency. However, it is important to develop means to determine the relationship between malnutrition and neuropsychiatric disorders in general. It focuses firstly on malnutrition, exploring the cognitive and central nervous system changes in those who would be found malnourished by the Waterlow criteria, before moving on to specific deficiencies and their associated neuropsychiatric presentations, such as B6 (pyridoxine) and epilepsy, or iron and neurodevelopmental disorders such as autism and attention-deficit/hyperactivity disorder.

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