Abstract
The present review addresses the question of whether and how neuropsychological tests assessing cognition in attention-deficit/hyperactivity disorder (ADHD) can contribute to clinical and scientific issues concerning ADHD. Neuropsychological studies have shown various though inconsistent cognitive deficits in patients with ADHD. While patients with ADHD, at group level, may differ from healthy participants in regard to cognitive functioning, there is no distinct psychometric cognitive test or profile allowing an individual diagnosis of ADHD or the identification of subtypes according to DSM. Psychometric neuropsychological tests may provide a precise description of the cognitive problems in individual patients and offer specific information for individualized treatment planning. In addition, neuropsychological assessment may contribute to neuroscientific research by providing endophenotypes or biological markers of ADHD. Cognitive neuropsychological assessment appears to be at present of limited clinical use and confined to individual descriptions.
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References
Aman CJ, Roberts RJ Jr, Pennington BF (1998) A neuropsychological examination of the underlying deficit in attention deficit hyperactivity disorder: frontal lobe versus right parietal lobe theories. Dev Psychol 34:956–969
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Arlington
Antshel KM, Faraone SV, Maglione K, Doyle AE, Fried R, Seidman LJ, Biederman J (2010) Executive functioning in high-IQ adults with ADHD. Psychol Med 40:1909–1918
Barkley RA (1991) The ecological validity of laboratory and analogue assessment methods of ADHD symptoms. J Abnorm Child Psychol 19:149–178
Barkley RA (2006) Attention-deficit hyperactive disorder: a handbook for diagnosis and treatment, 3rd edn. Guilford, New York
Barkley RA (2012) Executive functions: what they are, how they work, and why they evolved. Guilford, New York
Barnett R, Maruff P, Vance A (2005) An investigation of visuospatial memory impairment in children with attention deficit hyperactivity disorder (ADHD), combined type. Psychol Med 35:1433–1443
Benson DF (1991) The role of frontal dysfunction in attention deficit hyperactivity disorder. J Child Neurol 6:S9–S12
Berk LE, Landau S (1993) Private speech of learning disabled and normally achieving children in classroom academic and laboratory contexts. Child Dev 64:556–571
Biederman J, Faraone SV (2005) Attention-deficit/hyperactivity disorder. Lancet 366(9481):237–248
Biederman J, Faraone SV, Spencer T, Wilens T, Norman D, Lapey KA, Mick E, Lehman BK, Doyle A (1993) Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry 150:1792–1798
Biederman J, Faraone SV, Spencer T, Wilens T, Mick E, Lapey KA (1994) Gender differences in a sample of adults with attention deficit hyperactivity disorder. Psychiatry Res 53:13–29
Boucugnani LL, Jones RW (1989) Behaviors analogous to frontal lobe dysfunction in children with attention deficit hyperactivity disorder. Arch Clin Neuropsychol 4:161–173
Bruce B, Thernlund G, Nettelbladt U (2006) ADHD and language impairment: a study of the parent questionnaire FTF (Five to Fifteen). Eur Child Adolesc Psychiatry 15:52–60
Cao Q, Zang Y, Zhu C, Cao X, Sun L, Zhou X, Wang Y (2008) Alerting deficits in children with attention deficit/hyperactivity disorder: event-related fMRI evidence. Brain Res 1219:159–168
Casey BJ, Castellanos FX, Giedd JN, Marsh WL, Hamburger SD, Schubert AB, Vauss YC, Vaituzis AC, Dickstein DP, Sarfatti SE, Rapoport JL (1997) Implication of right frontostriatal circuitry in response inhibition and attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 36:374–383
Castellanos FX, Giedd JN, Marsh WL, Hamburger SD, Vaituzis AC, Dickstein DP, Sarfatti SE, Vauss YC, Snell JW, Lange N, Kaysen D, Krain AL, Ritchie GF, Rajapakse JC, Rapoport JL (1996) Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder. Arch Gen Psychiatry 53:607–616
Castellanos FX, Sonuga-Barke EJS, Milham MP, Tannock R (2006) Characterizing cognition in ADHD: beyond executive dysfunction. Trends Cogn Sci 10:117–123
Chaytor N, Schmitter-Edgecombe M (2003) The ecological validity of neuropsychological tests: a review of the literature on everyday cognitive skills. Neuropsychol Rev 13(4):181–197
Clements KM, Girard TA, Xing HC, Wainwright PE (2003) Spontaneously hypertensive and Wistar Kyoto rats differ in delayed matching-to-place performance and response to dietary long-chain polyunsaturated fatty acids. Dev Psychobiol 43:57–69
Cohen RA (1993) The neuropsychology of attention. Plenum Press, New York
Cook EH Jr, Stein MA, Krasowski MD, Cox NJ, Olkon DM, Kieffer JE, Leventhal BL (1995) Association of attention-deficit disorder and the dopamine transporter gene. Am J Hum Genet 56:993–998
Corkum PV, Siegel LS (1993) Is the continuous performance task a valuable research tool for use with children with attention-deficit-hyperactivity disorder? J Child Psychol Psychiatry 34:1217–1239
Doyle A, Biederman J, Seidman L, Weber W, Faraone S (2000) Diagnostic efficiency of neuropsychological test scores for discriminating boys with and without attention deficit-hyperactivity disorder. J Consult Clin Psychol 68(3):477–488
Fair DA, Bathula D, Nikolas MA, Nigg JT (2012) Distinct neuropsychological subgroups in typically developing youth inform heterogeneity in children with ADHD. Proc Natl Acad Sci USA 109(17):6769–6774
Faraone SV, Biederman J, Mick E (2006) The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 36(2):159–165
Filipek PA, Semrud-Clikeman M, Steingard RJ, Renshaw PF, Kennedy DN, Biederman J (1997) Volumetric MRI analysis comparing subjects having attention-deficit hyperactivity disorder with normal controls. Neurology 48:589–601
Frazier TW, Demaree HA, Youngstrom EA (2004) Meta-analysis of intellectual and neuropsychological test performance in attention deficit/hyperactivity disorder. Neuropsychology 18:543–555
Fuermaier ABM, Tucha L, Koerts J, Aschenbrenner S, Weisbrod M, Lange KW, Tucha O (2013a) Source discrimination in adults with attention deficit hyperactivity disorder. PLoS ONE 8:e65134
Fuermaier ABM, Tucha L, Koerts J, Aschenbrenner S, Westermann C, Weisbrod M, Lange KW, Tucha O (2013b) Complex prospective memory in adults with attention deficit hyperactivity disorder. PLoS ONE 8:e58338
Furman L (2005) What is attention-deficit hyperactivity disorder (ADHD)? J Child Neurol 20:994–1002
Gansler DA, Fucetola R, Krengel M, Stetson S, Zimering R, Makary C (1998) Are there cognitive subtypes in adult attention deficit/hyperactivity disorder? J Nerv Ment Dis 186:776–781
Geurts HM, Verté S, Oosterlaan J, Roeyers H, Sergeant JA (2005) ADHD subtypes: do they differ in their executive functioning profile? Arch Clin Neuropsychol 20(4):457–477
Hartsough CS, Lambert NM (1985) Medical factors in hyperactive and normal children: prenatal, developmental, and health history findings. Am J Orthopsychiatr 55:190–201
Hinshaw SP, Carte ET, Sami N, Treuting JJ, Zupan BA (2002) Preadolescent girls with attention-deficit/hyperactivity disorder: II. Neuropsychological performance in relation to subtypes and individual classification. J Consult Clin Psychol 70:1099–1111
Hollingsworth DE, McAuliffe SP, Knowlton BJ (2001) Temporal allocation of visual attention in adult attention deficit hyperactivity disorder. J Cogn Neurosci 13:298–305
Homack S, Riccio CA (2004) A meta-analysis of the sensitivity and specificity of the Stroop Color and Word Test with children. Arch Clin Neuropsychol 19:725–743
Horton AM Jr (1996) Neuropsychological findings in adult attention deficit disorder: a pilot study. Appl Neuropsychol 3:181–183
Huang-Pollock CL, Nigg JT, Carr TH (2005) Deficient attention is hard to find: applying the perceptual load model of selective attention to attention deficit hyperactivity disorder subtypes. J Child Psychol Psychiatry 46:1211–1218
Hynd GW, Hern KL, Novey ES, Eliopulos D, Marshall R, Gonzalez JJ, Voeller KK (1993) Attention deficit-hyperactivity disorder and asymmetry of the caudate nucleus. J Child Neurol 8:339–347
Jenkins M, Cohen R, Malloy P, Salloway S, Johnson EG, Penn J, Marcotte A (1998) Neuropsychological measures which discriminate among adults with residual symptoms of attention deficit disorder and other attentional complaints. Clin Neuropsychol 12:74–83
Jonkman LM, Kemner C, Verbaten MN, Van Engeland H, Kenemans JL, Camfferman G, Buitelaar JK, Koelega HS (1999) Perceptual and response interference in children with attention-deficit hyperactivity disorder, and the effects of methylphenidate. Psychophysiology 36:419–429
Kaplan RF, Stevens MC (2002) A review of adult ADHD: a neuropsychological and neuroimaging perspective. CNS Spectr 7:355–362
Kaplan BJ, Dewey D, Crawford SG, Fisher GC (1998) Deficits in long-term memory are not characteristic of ADHD. Attention deficit hyperactivity disorder. J Clin Exp Neuropsychol 20:518–528
Klingberg T, Fernell E, Olesen PJ, Johnson M, Gustafsson P, Dahlström K, Gillberg CG, Forssberg H, Westerberg H (2005) Computerized training of working memory in children with ADHD—a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry 44:177–186
Klorman R, Hazel-Fernandez LA, Shaywitz SE, Fletcher JM, Marchione KE, Holahan JM, Stuebing KK, Shaywitz BA (1999) Executive functioning deficits in attention-deficit/hyperactivity disorder are independent of oppositional defiant or reading disorder. J Am Acad Child Adolesc Psychiatry 38:1148–1155
Kovner R, Budman C, Frank Y, Sison C, Lesser M, Halperin J (1998) Neuropsychological testing in adult attention deficit hyperactivity disorder: a pilot study. Int J Neurosci 96:225–235
Koziol LF, Budding D (2012) Requiem for a diagnosis: attention-deficit hyperactivity disorder. Appl Neuropsychol Child 1:2–5
LaHoste GJ, Swanson JM, Wigal SB, Glabe C, Wigal T, King N, Kennedy JL (1996) Dopamine D4 receptor gene polymorphism is associated with attention deficit hyperactivity disorder. Mol Psychiatry 1:121–124
Lange KW, Tucha L, Walitza S, Gerlach M, Linder M, Tucha O (2007) Interaction of attention and graphomotor functions in children with attention deficit hyperactivity disorder. J Neural Transm Suppl 72:249–259
Lange KW, Reichl S, Lange KM, Tucha L, Tucha O (2010a) The history of attention deficit hyperactivity disorder. Atten Defic Hyperact Disord 2:241–255
Lange KW, Tucha L, Tucha O (2010b) Neuropsychologische Diagnostik: Ökologische Validität und Prognosen. In: Frommelt P, Lösslein H (eds) NeuroRehabilitation. Springer, Berlin, pp 759–770
Lawrence V, Houghton S, Douglas G, Durkin K, Whiting K, Tannock R (2004) Executive function and ADHD: a comparison of children’s performance during neuropsychological testing and real-world activities. J Attent Disord 7:137–149
Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment, 4th edn. Oxford University Press, New York
Lorch EP, Milich R, Flake RA, Ohlendorf J, Little S (2010) A developmental examination of story recall and coherence among children with ADHD. J Abnorm Child Psychol 38:291–301
Losier BJ, McGrath PJ, Klein RM (1996) Error patterns on the continuous performance test in non-medicated and medicated samples of children with and without ADHD: a meta-analytic review. J Child Psychol Psychiatry 37:971–987
Lovejoy DW, Ball JD, Keats M, Stutts ML, Spain EH, Janda L, Janusz J (1999) Neuropsychological performance of adults with attention deficit hyperactivity disorder (ADHD): diagnostic classification estimates for measures of frontal lobe/executive functioning. J Int Neuropsychol Soc 5:222–233
Manly T, Anderson V, Nimmo-Smith I, Turner A, Watson P, Robertson IH (2001) The differential assessment of children’s attention: the Test of Everyday Attention for Children (TEA-Ch), normative sample and ADHD performance. J Child Psychol Psychiatry 42:1065–1081
Martinussen R, Hayden J, Hogg-Johnson S, Tannock R (2005) A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 44:377–384
McLean A, Dowson J, Toone B, Young S, Bazanis E, Robbins TW, Sahakian BJ (2004) Characteristic neurocognitive profile associated with adult attention-deficit/hyperactivity disorder. Psychol Med 34:681–692
Muir-Broaddus JE, Rosenstein LD, Medina DE, Soderberg C (2002) Neuropsychological test performance of children with ADHD relative to test norms and parent behavioral ratings. Arch Clin Neuropsychol 17:671–689
Nigg JT, Blaskey LG, Huang-Pollock CL, Rappley MD (2002) Neuropsychological executive functions and DSM-IV ADHD subtypes. J Am Acad Child Adolesc Psychiatry 41:59–66
Paule M, Rowland A, Ferguson S, Chelonis J, Tannock R, Swanson J, Castellanos F (2000) Attention deficit/hyperactivity disorder: characteristics, interventions, and models. Neurotoxicol Teratol 22:631–651
Pollak Y, Kahana-Vax G, Hoofien D (2008) Retrieval processes in adults with ADHD: a RAVLT study. Dev Neuropsychol 33:62–73
Quinlan DM, Brown TE (2003) Assessment of short-term verbal memory impairments in adolescents and adults with ADHD. J Attent Disord 6:143–152
Rolfe MH, Hamm JP, Waldie KE (2008) Differences in paper and pencil versus computerized line bisection according to ADHD subtype and hand-use. Brain Cogn 66:188–195
Rommelse NN, Altink ME, Martin NC, Buschgens CJ, Buitelaar JK, Sergeant JA, Oosterlaan J (2008) Neuropsychological measures probably facilitate heritability research of ADHD. Arch Clin Neuropsychol 23:579–591
Sami N, Carte ET, Hinshaw SP, Zupan BA (2003) Performance of girls with ADHD and comparison girls on the Rey-Osterrieth Complex Figure: evidence for executive processing deficits. Child Neuropsychol 9:237–254
Schreiber HE, Javorsky DJ, Robinson JE, Stern RA (1999) Rey-Osterrieth Complex Figure performance in adults with attention deficit hyperactivity disorder: a validation study of the Boston Qualitative Scoring System. Clin Neuropsychol 13:509–520
Schweitzer JB, Faber TL, Grafton ST, Tune LE, Hoffman JM, Kilts CD (2000) Alterations in the functional anatomy of working memory in adult attention deficit hyperactivity disorder. Am J Psychiatry 157:278–280
Seidman LJ, Biederman J, Weber W, Hatch M, Faraone SV (1998) Neuropsychological function in adults with attention-deficit hyperactivity disorder. Biol Psychiatry 44:260–268
Sergeant JA, Geurts H, Oosterlaan J (2002) How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder? Behav Brain Res 130:3–28
Sheppard DM, Bradshaw JL, Mattingley JB, Lee P (1999) Effects of stimulant medication on the lateralisation of line bisection judgements of children with attention deficit hyperactivity disorder. J Neurol Neurosurg Psychiatry 66:57–63
Shue KL, Douglas VI (1992) Attention deficit hyperactivity disorder and the frontal lobe syndrome. Brain Cogn 20:104–124
Sonuga-Barke EJS (2005) Causal models of attention-deficit/hyperactivity disorder: from common simple deficits to multiple developmental pathways. Biol Psychiatry 57:1231–1238
Spooner DM, Pachana NA (2006) Ecological validity in neuropsychological assessment: a case for greater consideration in research with neurologically intact populations. Arch Clin Neuropsychol 21:327–337
Taylor EA, Sandberg S, Thorley G, Giles S (1991) The epidemiology of childhood hyperactivity. Oxford University Press, London
Thome J, Ehlis AC, Fallgatter AJ, Krauel K, Lange KW, Riederer P, Romanos M, Taurines R, Tucha O, Uzbekov M, Gerlach M (2012) Biomarkers for attention-deficit/hyperactivity disorder (ADHD). A consensus report of the WFSBP task force on biological markers and the World Federation of ADHD. World J Biol Psychiatry 13:379–400
Tucha O, Lange KW (2001) Effects of methylphenidate on kinematic aspects of handwriting in hyperactive boys. J Abnorm Child Psychol 29:351–356
Tucha O, Mecklinger L, Laufkötter R, Kaunzinger I, Paul GM, Klein HE, Lange KW (2005) Clustering and switching on verbal and figural fluency functions in adults with attention deficit hyperactivity disorder. Cogn Neuropsychiatr 10:231–248
Tucha O, Prell S, Mecklinger L, Bormann-Kischkel C, Kübber S, Linder M, Walitza S, Lange KW (2006a) Effects of methylphenidate on multiple components of attention in children with attention deficit hyperactivity disorder. Psychopharmacology 185:315–326
Tucha O, Walitza S, Mecklinger L, Sontag TA, Kübber S, Linder M, Lange KW (2006b) Attentional functioning in children with ADHD—predominantly hyperactive-impulsive type and children with ADHD—combined type. J Neural Transm 113:1943–1953
Tucha L, Tucha O, Laufkötter R, Walitza S, Klein HE, Lange KW (2008) Neuropsychological assessment of attention in adults with different subtypes of attention deficit/hyperactivity disorder. J Neural Transm 115:269–278
Tucha L, Tucha O, Walitza S, Sontag TA, Laufkötter R, Linder M, Lange KW (2009) Vigilance and sustained attention in children and adults with ADHD. J Atten Disord 12:410–421
Tucha L, Tucha O, Sontag TA, Stasik D, Laufkötter R, Lange KW (2011) Differential effects of methylphenidate on problem solving in adults with ADHD. J Atten Disord 15:161–173
Vaidya CJ, Austin G, Kirkorian G, Ridlehuber HW, Desmond JE, Glover GH, Gabrieli JD (1998) Selective effects of methylphenidate in attention deficit hyperactivity disorder: a functional magnetic resonance study. Proc Natl Acad Sci USA 95:14494–14499
van Mourik R, Oosterlaan J, Sergeant JA (2005) The Stroop revisited: a meta-analysis of interference control in AD/HD. J Child Psychol Psychiatry 46:150–165
van Zomeren AH, Brouwer WH (1994) Clinical neuropsychology of attention. Oxford University Press, New York
Vancassel S, Blondeau C, Lallemand S, Chador M, Linard A, Lavialle M, Dellu-Hagedorn F (2007) Hyperactivity in the rat is associated with spontaneous low level of n-3 polyunsaturated fatty acids in the frontal cortex. Behav Brain Res 180:119–126
Wankerl B, Hauser J, Makulska-Gertruda E, Reißmann A, Sontag TA, Tucha O, Lange KW (2014) Neurobiology of attention deficit hyperactivity disorder. Fortschr Neurol Psychiatr 82:9–29
Wassenberg R, Hendriksen JG, Hurks PP, Feron FJ, Vles JS, Jolles J (2010) Speed of language comprehension is impaired in ADHD. J Attent Disord 13:374–385
Westerberg H, Hirvikoski T, Forssberg H, Klingberg T (2004) Visuo-spatial working memory span: a sensitive measure of cognitive deficits in children with ADHD. Child Neuropsychol 10:155–161
Weyandt LL, Rice JA, Linterman I, Mitzlaff L, Emert E (1998) Neuropsychological performance of a sample of adults with ADHD, developmental reading disorder, and controls. Dev Neuropsychol 14:643–656
White RF, Campbell R, Echeverria D, Knox SS, Janulewicz P (2009) Assessment of neuropsychological trajectories in longitudinal population-based studies of children. J Epidemiol Commun Health 63(Suppl 1):i15–i26
Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF (2005) Validity of the executive function theory of attention deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 57:1336–1346
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Lange, K.W., Hauser, J., Lange, K.M. et al. Utility of cognitive neuropsychological assessment in attention-deficit/hyperactivity disorder. ADHD Atten Def Hyp Disord 6, 241–248 (2014). https://doi.org/10.1007/s12402-014-0132-3
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DOI: https://doi.org/10.1007/s12402-014-0132-3