Using Brain-Based Cognitive Measures to Support Clinical Decisions in ADHD

L M Williams; Daniel F Hermens; T Thein; C R Clark; N J Cooper; S D Clarke; C Lamb; E Gordon; M R Kohn

doi:10.1016/j.pediatrneurol.2009.08.010

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Using Brain-Based Cognitive Measures to Support Clinical Decisions in ADHD

Journal article

Peer reviewed

Using Brain-Based Cognitive Measures to Support Clinical Decisions in ADHD

L M Williams, Daniel F Hermens, T Thein, C R Clark, N J Cooper, S D Clarke, C Lamb, E Gordon and M R Kohn

Pediatric Neurology, Vol.42(2), pp.118-126

2010

DOI: https://doi.org/10.1016/j.pediatrneurol.2009.08.010

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Abstract

Measures of cognition support diagnostic and treatment decisions in attention deficit hyperactivity disorder. We used an integrative neuroscience framework to assess cognition and associated brain-function correlates in large attention deficit hyperactivity disorder and healthy groups. Matched groups of 175 attention deficit hyperactivity disorder children/adolescents and 175 healthy control subjects were assessed clinically, with the touch screen-based cognitive assessment battery "IntegNeuro" (Brain Resource Ltd., Sydney, Australia) and the "LabNeuro" (Brain Resource Ltd., Sydney, Australia) platform for psychophysiologic recordings of brain function and body arousal. IntegNeuro continuous performance task measures of sustained attention classified 68% of attention deficit hyperactivity disorder patients with 76% specificity, consistent with previous reports. Our additional cognitive measures of impulsivity, intrusive errors, inhibition, and response variability improved sensitivity to 88%, and specificity to 91%. Positive predictive power was 96%, and negative predictive power, 88%. These metrics were stable across attention deficit hyperactivity disorder subtypes and age. Consistent with their brain-based validity, cognitive measures were correlated with corresponding brain-function and body-arousal measures. We propose a combination of candidate cognitive "markers" that define a signature for attention deficit hyperactivity disorder: "sustained attention," "impulsivity," "inhibition," "intrusions," and "response variability." These markers offer a frame of reference to support diagnostic and treatment decisions, and an objective benchmark for monitoring outcomes of interventions. © 2010 Elsevier Inc. All rights reserved.

Details

Title: Using Brain-Based Cognitive Measures to Support Clinical Decisions in ADHD
Authors: L M Williams (Author) - University of Sydney
Daniel F Hermens (Author) - University of Sydney
T Thein (Author) - University of Sydney
C R Clark (Author) - Flinders University
N J Cooper (Author) - Brain Resource
S D Clarke (Author) - University of Sydney
C Lamb (Author) - Flinders Medical Centre
E Gordon (Author) - University of Sydney
M R Kohn (Author) - University of Sydney
Publication details: Pediatric Neurology, Vol.42(2), pp.118-126
Publisher: Elsevier Inc.
DOI: 10.1016/j.pediatrneurol.2009.08.010
ISSN: 0887-8994
Organisation Unit: Thompson Institute; University of the Sunshine Coast, Queensland
Language: English
Record Identifier: 99450438602621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Clinical Neurology; Pediatrics

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