title: Delayed maturation in brain electrical activity partially explains the association between early environmental deprivation and symptoms of attention-deficit/hyperactivity disorder.
abstract: BACKGROUND
  Children raised in institutional settings are exposed to social and environmental circumstances that may deprive them of expected environmental inputs during sensitive periods of brain development that are necessary to foster healthy development. This deprivation is thought to underlie the abnormalities in neurodevelopment that have been found in previously institutionalized children. It is unknown whether deviations in neurodevelopment explain the high rates of developmental problems evident in previously institutionalized children, including psychiatric disorders.
  
  
  METHODS
  We present data from a sample of children raised in institutions in Bucharest, Romania (n = 117) and an age- and sex-matched sample of community control subjects (n = 49). Electroencephalogram data were acquired following entry into the study at age 6 to 30 months, and a structured diagnostic interview of psychiatric disorders was completed at age 54 months.
  
  
  RESULTS
  Children reared in institutions evidenced greater symptoms of attention-deficit/hyperactivity disorder, anxiety, depression, and disruptive behavior disorders than community controls. Electroencephalogram revealed significant reductions in alpha relative power and increases in theta relative power among children reared in institutions in frontal, temporal, and occipital regions, suggesting a delay in cortical maturation. This pattern of brain activity predicted symptoms of hyperactivity and impulsivity at age 54 months, and significantly mediated the association between institutionalization and attention-deficit/hyperactivity disorder symptoms. Electroencephalogram power was unrelated to depression, anxiety, or disruptive behaviors.
  
  
  CONCLUSIONS
  These findings document a potential neurodevelopmental mechanism underlying the association between institutionalization and psychiatric morbidity. Deprivation in social and environmental conditions may perturb early patterns of neurodevelopment and manifest as psychiatric problems later in life.
authors.affiliation: Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Katie A
authors.initials: KA
authors.lastname: McLaughlin
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Fox
authors.forename: Charles H
authors.initials: CH
authors.lastname: Zeanah
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Sheridan
authors.forename: Peter
authors.initials: P
authors.lastname: Marshall
authors.forename: Charles A
authors.initials: CA
authors.lastname: Nelson
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000254:growth & development* / Q000503:physiopathology; D058256:Brain Waves / Q000502:physiology*; D016022:Case-Control Studies; D002657:Child Development / Q000502:physiology*; D002669:Child Welfare; D002675:Child, Preschool; D004777:Environment; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D016555:Matched-Pair Analysis; D001523:Mental Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D019372:Orphanages; D002666:Psychology, Child; D011610:Psychosocial Deprivation; D012016:Reference Values