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Neuropsychological Performance of Youth with Secondary Attention-Deficit/Hyperactivity Disorder 6- and 12-Months after Traumatic Brain Injury

Published online by Cambridge University Press:  09 December 2014

Tisha J. Ornstein ,
Sanya Sagar ,
Russell J. Schachar ,
Linda Ewing-Cobbs ,
Sandra B. Chapman ,
Maureen Dennis ,
Ann E. Saunders ,
Tony T. Yang ,
Harvey S. Levin  and
Jeffrey E. Max
Tisha J. Ornstein
Affiliation:
Department of Psychology, Ryerson University, Toronto, Canada
Sanya Sagar
Affiliation:
Department of Psychology, Ryerson University, Toronto, Canada
Russell J. Schachar
Affiliation:
Department of Psychiatry, Neurosciences and Mental Health and Brain and Behaviour Program, Research Institute, The Hospital for Sick Children, Toronto, Canada
Linda Ewing-Cobbs
Affiliation:
Department of Pediatrics, University of Texas Health Science Center, Houston, Texas
Sandra B. Chapman
Affiliation:
Center for Brain Health, The University of Texas at Dallas, Dallas, Texas
Maureen Dennis
Affiliation:
Department of Psychology, Brain and Behaviour Program, Research Institute, The Hospital for Sick Children, Toronto, Canada
Ann E. Saunders
Affiliation:
Department of Psychiatry, University of Texas Health Science Center, Houston, Texas
Tony T. Yang
Affiliation:
Department of Psychiatry, University of California, San Francisco, California
Harvey S. Levin
Affiliation:
Department of Physical Medicine and Rehabilitation, Department of Neurosurgery, and Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
Jeffrey E. Max*
Affiliation:
Department of Psychiatry, University of California, San Diego, and Rady Children’s Hospital, San Diego, California
*
Correspondence and reprint requests to: Jeffrey Max, Rady Children’s Hospital, 3020 Children’s Way, MC 5018, San Diego, CA 92123. E-mail: jmax@ucsd.edu
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Abstract

The present study compared executive dysfunction among children with attention-deficit/hyperactivity disorder (ADHD) after traumatic brain injury (TBI), also called secondary ADHD (S-ADHD), pre-injury ADHD and children with TBI only (i.e., no ADHD). Youth aged 6–16 years admitted for TBI to five trauma centers were enrolled (n=177) and evaluated with a semi-structured psychiatric interview scheduled on three occasions (within 2 weeks of TBI, i.e., baseline assessment for pre-injury status; 6-months and 12-months post-TBI). This permitted the determination of 6- and 12-month post-injury classifications of membership in three mutually exclusive groups (S-ADHD; pre-injury ADHD; TBI-only). Several executive control measures were administered. Unremitted S-ADHD was present in 17/141 (12%) children at the 6-month assessment, and in 14/125 (11%) children at 12-months post-injury. The study found that children with S-ADHD exhibited deficient working memory, attention, and psychomotor speed as compared to children with pre-injury ADHD. Furthermore, the children with S-ADHD and the children with TBI-only were impaired compared to the children with pre-injury ADHD with regard to planning. No group differences related to response inhibition emerged. Age, but not injury severity, gender, or adaptive functioning was related to executive function outcome. Neuropsychological sequelae distinguish among children who develop S-ADHD following TBI and those with TBI only. Moreover, there appears to be a different pattern of executive control performance in those who develop S-ADHD than in children with pre-injury ADHD suggesting that differences exist in the underlying neural mechanisms that define each disorder, underscoring the need to identify targeted treatment interventions. (JINS, 2014, 20, 971–981)

Keywords

Traumatic brain injuryChildrenAdolescentsS-ADHDP-ADHDNeurocognitive function
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 10 , November 2014 , pp. 971 - 981
Copyright
Copyright © The International Neuropsychological Society 2014 

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Footnotes

*

Deceased – formerly affiliated with the Department of Psychology, The Hopsital for Sick Chlidren.

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