Attention deficit hyperactivity disorder and neurocognitive correlates after childhood stroke.
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.
Max
Jeffrey E
JE
University of California, San Diego, USA. jmax@ucsd.edu
Mathews
Katherine
K
Manes
Facundo F
FF
Robertson
Brigitte A M
BA
Fox
Peter T
PT
Lancaster
Jack L
JL
Lansing
Amy E
AE
Schatz
Amy
A
Collings
Nicole
N
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000503:physiopathology*; D003071:Cognition; D005192:Family Health; D005260:Female; D007839:Functional Laterality; D006801:Humans; D015994:Incidence; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D009042:Motivation; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010552:Personality Assessment; D011340:Problem Solving; D020521:Stroke / Q000453:epidemiology / Q000503:physiopathology*; D014888:Wechsler Scales