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Attention deficit hyperactivity disorder and neurocognitive correlates after childhood stroke

Published online by Cambridge University Press:  27 August 2003

Jeffrey E. Max ,
Katherine Mathews ,
Facundo F. Manes ,
Brigitte A.M. Robertson ,
Peter T. Fox ,
Jack L. Lancaster ,
Amy E. Lansing ,
Amy Schatz  and
Nicole Collings
Jeffrey E. Max*
Affiliation:
University of California, San Diego and Children's Hospital and Health Center, San Diego, California
Katherine Mathews
Affiliation:
University of Iowa, Department of Pediatrics and Neurology, Iowa City, Iowa
Facundo F. Manes
Affiliation:
Raul Carrea Institute for Neurological Research—FLENI, Buenos Aires, Argentina
Brigitte A.M. Robertson
Affiliation:
GlaxoSmithKline, Research Triangle Park, North Carolina
Peter T. Fox
Affiliation:
Research Imaging Center, University of Texas Health Science Center, San Antonio, Texas
Jack L. Lancaster
Affiliation:
Research Imaging Center, University of Texas Health Science Center, San Antonio, Texas
Amy E. Lansing
Affiliation:
Children's Hospital and Health Center, Department of Psychiatry, San Diego, California
Amy Schatz
Affiliation:
Children's Hospital and Health Center, Department of Psychiatry, San Diego, California
Nicole Collings
Affiliation:
Children's Hospital and Health Center, Department of Psychiatry, San Diego, California
*
*Reprint requests to: Jeffrey E. Max, M.B.B.Ch, Children's Hospital and Health Center, San Diego, 3020 Children's Way, MC 5033, San Diego, CA 92123. E-mail: jmax@ucsd.edu
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Abstract

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. (JINS, 2003, 9, 815–829.)

Keywords

ADHDChildhood strokeCognitionApathyClubfootScoliosis
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 9 , Issue 6 , September 2003 , pp. 815 - 829
Copyright
Copyright © The International Neuropsychological Society 2003

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