Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-23T23:19:48.869Z Has data issue: false hasContentIssue false
  • English
  • Français

A longitudinal examination of neuropsychological and clinical functioning in boys with attention deficit hyperactivity disorder (ADHD): improvements in executive functioning do not explain clinical improvement

Published online by Cambridge University Press:  19 July 2013

D. R. Coghill ,
D. Hayward ,
S. M. Rhodes ,
C. Grimmer  and
K. Matthews
D. R. Coghill*
Affiliation:
Division of Neuroscience, Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK
D. Hayward
Affiliation:
NHS Tayside, Murray Royal Hospital, Perth, UK
S. M. Rhodes
Affiliation:
School of Psychological Sciences and Health, University of Strathclyde, Graham Hills Building, Glasgow, UK
C. Grimmer
Affiliation:
NHS Fife Child and Adolescent Mental Health Services, Stratheden Hospital, Stratheden, Cupar, Fife, UK
K. Matthews
Affiliation:
Division of Neuroscience, Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK
*
*Address for correspondence: D. R. Coghill, Ph.D., Division of Neuroscience, Ninewells Hospital, Dundee DD1 9SY, UK. (Email: d.r.coghill@dundee.ac.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Attention deficit hyperactivity disorder (ADHD) often, but not always, persists into adulthood. Investigations of the associations between clinical and biological markers of persistence can shed light on causal pathways. It has been proposed that compensatory improvements in executive neuropsychological functioning are associated with clinical improvements. This is the first study to test this hypothesis prospectively.

Method

The clinical and neuropsychological functioning of 17 boys with ADHD (mean age 10.45 years at time 1; 14.65 years at time 2) and 17 typically developing (TYP) boys (mean age 10.39 years at time 1; 14.47 years at time 2) was tested on two occasions, 4 years apart. This was done using a battery of standardized neuropsychological tests that included tasks with high and low executive demands.

Results

Clinical improvements were observed over time. Neuropsychological performance improvements were also evident, with ADHD boys developing with a similar pattern to TYP boys, but with a developmental lag. Whilst there was an association between reduced symptoms and superior performance at retest for one task with a high executive demand (spatial working memory), this was not seen with two further high executive demand tasks [Stockings of Cambridge and intra-dimensional extra-dimensional (ID/ED) set shifting]. Also, there was no association between change in executive functioning and change in symptoms. Baseline performance on the ID/ED set-shifting task predicted better clinical outcome. Only change in performance on the low executive demand delayed matching-to-sample task predicted better clinical outcome.

Conclusions

These data highlight the importance of longitudinal measurements of cognition, symptoms and treatment response over time in children and adolescents with ADHD.

Keywords

Attention deficit hyperactivity disorderexecutive functioninglongitudinal studiesmemoryneuropsychologyoutcome
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 5 , April 2014 , pp. 1087 - 1099
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bedard, AC, Trampush, JW, Newcorn, JH, Halperin, JM (2010). Perceptual and motor inhibition in adolescents/young adults with childhood-diagnosed ADHD. Neuropsychology 24, 424–434.Google Scholar
Biederman, J, Faraone, S, Milberger, S, Curtis, S, Chen, L, Marrs, A, Ouellette, C, Moore, P, Spencer, T (1996 a). Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry 35, 343–351.Google Scholar
Biederman, J, Faraone, S, Milberger, S, Guite, J, Mick, E, Chen, L, Mennin, D, Marrs, A, Ouellette, C, Moore, P, Spencer, T, Norman, D, Wilens, T, Kraus, I, Perrin, J (1996 b). A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Archives of General Psychiatry 53, 437–446.Google Scholar
Biederman, J, Petty, CR, Fried, R, Doyle, AE, Spencer, T, Seidman, LJ, Gross, L, Poetzl, K, Faraone, SV (2007). Stability of executive function deficits into young adult years: a prospective longitudinal follow-up study of grown up males with ADHD. Acta Psychiatrica Scandanavia 116, 129–136.Google Scholar
Coghill, D, Sonuga-Barke, EJ (2012). Annual Research Review: categories versus dimensions in the classification and conceptualisation of child and adolescent mental disorders – implications of recent empirical study. Journal of Child Psychology and Psychiatry 53, 469–489.CrossRefGoogle ScholarPubMed
Coghill, DR (2010). Heterogeneity in hyperkinetic disorder. M.D. Thesis. University of Dundee: Dundee.Google Scholar
Coghill, DR, Rhodes, SM, Matthews, K (2007). The neuropsychological effects of chronic methylphenidate on drug-naive boys with attention-deficit/hyperactivity disorder. Biological Psychiatry 62, 954–962.CrossRefGoogle ScholarPubMed
Dunn, L, Dunn, L, Whetton, C, Burley, J (1997). British Picture Vocabulary Scale, 2nd edn. NFER-Nelson: London.Google Scholar
Faraone, SV, Biederman, J, Mick, E (2006). The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychological Medicine 36, 159–165.Google Scholar
Fayyad, J, de Graaf, R, Kessler, R, Alonso, J, Angermeyer, M, Demyttenaere, K, de Girolamo, G, Haro, JM, Karam, EG, Lara, C, Lépine, JP, Ormel, J, Posada-Villa, J, Zaslavsky, AM, Jin, R (2007). Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. British Journal of Psychiatry 190, 402–409.Google Scholar
Gittelman, R, Mannuzza, S, Shenker, R, Bonagura, N (1985). Hyperactive boys almost grown up. I. Psychiatric status. Archives of General Psychiatry 42, 937–947.CrossRefGoogle ScholarPubMed
Halperin, JM, Schulz, KP (2006). Revisiting the role of the prefrontal cortex in the pathophysiology of attention-deficit/hyperactivity disorder. Psychological Bulletin 132, 560–581.CrossRefGoogle ScholarPubMed
Halperin, JM, Trampush, JW, Miller, CJ, Marks, DJ, Newcorn, JH (2008). Neuropsychological outcome in adolescents/young adults with childhood ADHD: profiles of persisters, remitters and controls. Journal of Child Psychology and Psychiatry 49, 958–966.Google Scholar
Hart, EL, Lahey, BB, Loeber, R, Applegate, B, Frick, PJ (1995). Developmental change in attention-deficit hyperactivity disorder in boys: a four-year longitudinal study. Journal of Abnormal Child Psychology 23, 729–749.CrossRefGoogle Scholar
Holmes, J, Gathercole, SE, Place, M, Dunning, DL, Hilton, KA, Elliott, JG (2010). Working memory deficits can be overcome: impacts of training and medication on working memory in children with ADHD. Applied Cognitive Psychology 24, 827–836.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.Google Scholar
Kempton, S, Vance, A, Maruff, P, Luk, E, Costin, J, Pantelis, C (1999). Executive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children. Psychological Medicine 29, 527–538.Google Scholar
Kessler, RC, Adler, L, Barkley, R, Biederman, J, Conners, CK, Demler, O, Faraone, SV, Greenhill, LL, Howes, MJ, Secnik, K, Spencer, T, Ustun, TB, Walters, EE, Zaslavsky, AM (2006). The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of Psychiatry 163, 716–723.Google Scholar
Kessler, RC, Adler, LA, Barkley, R, Biederman, J, Conners, CK, Faraone, SV, Greenhill, LL, Jaeger, S, Secnik, K, Spencer, T, Ustun, TB, Zaslavsky, AM (2005). Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: results from the National Comorbidity Survey Replication. Biological Psychiatry 57, 1442–1451.Google Scholar
Klingberg, T, Fernell, E, Olesen, PJ, Johnson, M, Gustafsson, P, Dahlstrom, K, Gillberg, CG, Forssberg, H, Westerberg, H (2005). Computerized training of working memory in children with ADHD – a randomized, controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry 44, 177–186.Google Scholar
Lara, C, Fayyad, J, de Graff, R, Kessler, RC, Aguilar-Gaxiola, S, Angermeyer, M, Demytteneare, K, de Girolamo, G, Haro, JM, Jin, R, Karam, EG, Lépine, JP, Mora, ME, Ormel, J, Posada-Villa, J, Sampson, N (2009). Childhood predictors of adult attention-deficit/hyperactivity disorder: results from the World Health Organization World Mental Health Survey Initiative. Biological Psychiatry 65, 46–54.Google Scholar
Li, J, Kang, C, Zhang, H, Wang, Y, Zhou, R, Wang, B, Guan, L, Yang, L, Faraone, SV (2007). Monoamine oxidase A gene polymorphism predicts adolescent outcome of attention-deficit/hyperactivity disorder. American Journal of Medical Genetics Part B Neuropsychiatric Genetics 144B, 430–433.Google Scholar
Mackie, S, Shaw, P, Lenroot, R, Pierson, R, Greenstein, DK, Nugent, TF III, Sharp, WS, Giedd, JN, Rapoport, JL (2007). Cerebellar development and clinical outcome in attention deficit hyperactivity disorder. American Journal of Psychiatry 164, 647–655.Google Scholar
Morris, RC, Evendon, JL, Sahakian, BJ, Robbins, TW (1987). Computer-aided assessment of dementia: comparative studies of neuropsychological deficits in Alzheimer-type dementia and Parkinson's disease. In Cognitive Neurochemistry (ed. Stahl, S. M., Iverson, S. D. and Goodman, E. C.), pp. 21–36. Oxford University Press: Oxford.Google Scholar
Nigg, JT, Willcutt, EG, Doyle, AE, Sonuga-Barke, EJ (2005). Causal heterogeneity in attention-deficit/hyperactivity disorder: do we need neuropsychologically impaired subtypes? Biological Psychiatry 57, 1224–1230.Google Scholar
Petrides, M, Milner, B (1982). Deficits on subject-ordered tasks after frontal- and temporal-lobe lesions in man. Neuropsychologia 20, 249–262.CrossRefGoogle ScholarPubMed
Rhodes, SM, Coghill, DR, Matthews, K (2004). Methylphenidate restores visual memory, but not working memory function in attention deficit-hyperkinetic disorder. Psychopharmacology (Berlin) 175, 319–330.Google Scholar
Rhodes, SM, Coghill, DR, Matthews, K (2005). Neuropsychological functioning in stimulant-naive boys with hyperkinetic disorder. Psychological Medicine 35, 1109–1120.Google Scholar
Rhodes, SM, Coghill, DR, Matthews, K (2006). Acute neuropsychological effects of methylphenidate in stimulant drug-naive boys with ADHD II – broader executive and non-executive domains. Journal of Child Psychology and Psychiatry 47, 1184–1194.Google Scholar
Sahakian, BJ, Owen, AM (1992). Computerized assessment in neuropsychiatry using CANTAB: discussion paper. Journal of the Royal Society of Medicine 85, 399–402.Google Scholar
Shallice, T (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society London B Biological Sciences 298, 199–209.Google Scholar
Shaw, P, Eckstrand, K, Sharp, W, Blumenthal, J, Lerch, JP, Greenstein, D, Clasen, L, Evans, A, Giedd, J, Rapoport, JL (2007 a). Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proceedings of the National Academy of Sciences USA 104, 19649–19654.Google Scholar
Shaw, P, Gornick, M, Lerch, J, Addington, A, Seal, J, Greenstein, D, Sharp, W, Evans, A, Giedd, JN, Castellanos, FX, Rapoport, JL (2007 b). Polymorphisms of the dopamine D4 receptor, clinical outcome, and cortical structure in attention-deficit/hyperactivity disorder. Archives of General Psychiatry 64, 921–931.CrossRefGoogle ScholarPubMed
Shaw, P, Lerch, J, Greenstein, D, Sharp, W, Clasen, L, Evans, A, Giedd, J, Castellanos, FX, Rapoport, J (2006). Longitudinal mapping of cortical thickness and clinical outcome in children and adolescents with attention-deficit/hyperactivity disorder. Archives of General Psychiatry 63, 540–549.Google Scholar
Sonuga-Barke, EJ, Brandeis, D, Cortese, S, Daley, D, Ferrin, M, Holtmann, M, Stevenson, J, Danckaerts, M, van der Oord, S, Dopfner, M, Dittmann, RW, Simonoff, E, Zuddas, A, Banaschewski, T, Buitelaar, J, Coghill, D, Hollis, C, Konofal, E, Lecendreux, M, Wong, IC, Sergeant, J (2013). Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American Journal of Psychiatry 170, 275–289.Google Scholar
Taylor, E, Sandberg, S, Thorley, G, Giles, S (1991). The Epidemiology of ADHD. Oxford University Press: New York.Google Scholar
van Lieshout, M, Luman, M, Buitelaar, J, Rommelse, NN, Oosterlaan, J (2013). Does neurocognitive functioning predict future or persistence of ADHD? A systematic review. Clinical Psychology Reviews 33, 539–560.CrossRefGoogle ScholarPubMed
Weiss, G, Hechtman, L, Milroy, T, Perlman, T (1985). Psychiatric status of hyperactives as adults: a controlled prospective 15-year follow-up of 63 hyperactive children. Journal of the American Academy of Child and Adolescent Psychiatry 24, 211–220.Google Scholar