Lectures 9-13
Lecture 9 - ADHD
Ino to ADHD
- attention -deficit/hyperactivity disorder (ADHD)
- Developmental disorder
- Essential feature is pattern of inattention and/or hyperactivity-impulsivity
- Hyperactivity: excessive motor activity at inappropriate times
- Impulsivity: doing w/out thinking, not considering consequences
ADD vs ADHD
- According to latest DSM-5 ADD not a diagnosis
- Now ADHD w/out the hyperactive
Key features of ADHD
- Need to demonstrate consistent inattentiveness and hyperactivity, at school home, and
peer related engagements
- Context matters
- ADHD creates other problems in child’s life
- Academic performance suffers
- Social rejection
- Not intellectual disorder, but can impact grades due to inattentiveness
Prevalence of ADHD
- 7.2% worldwide
- Adult, 2.5%
- Diagnostic criteria can vary between studies
- Cultural context
- Most DSM-5 criteria based on elementary school boys in north America
Comorbidity of ADHD
- Only about ⅓ children are diagnosed w ADHD alone.majority are diagnosed w at least
one other DSM disorder
Genetics of ADHD
- Highest genetic loading
- Most successfully treated
- Elevated in first-degree biological relatives of individuals with ADHD
- Etiology of ADHD has been suggested to e up to 80% genetic
- Potentials environmental/developmental factors
- Specific mutation in dopamine reuptake transporter (DAT1) more likely to
exhibit symptoms of ADHD in children whose mothers smoked during pregnancy
- Perinatal hypoxia- temporary shortage of oxygen around time of birth - been
linked to development of ADHD
- No convincing evidence that artificial food dye can cause ADHD
- No evidence ADHD can be caused by sugar
Behavioural markers of ADHD
- Children w ADHD will usually opt for immediate reward in psychological studies
, - Rewards apparently have less of an influence over the behaviour of children with ADHD
- Children with ADHD impaired performance in go-no-go task
- Some evidence showing that children with ADHD take more risks in gambling
experiments
- Seems children with ADHD makes risky and impulsive decisions (frontal lobe and
dopamine sys impairment)
- Dual pathway model
Neuroimaging findings in ADHD
- Reduced grey matter in prefrontal cortex, striatum, cerebellum and corpus callosum
Treatment of ADHD
- Pharmacological treated options very effective
- Psychostimulant variety of drugs most common for ADHD treatment
- Popular drugs include methylphenidate (Ritalin/concerta), amphetamine (adderal)
and d-amphetamine (dexedrine)
How do ADHD medications work?
- Amphetamines all generally work through similar mechanisms to boat dopamine and
norepinephrine signaling
- Theory is that individuals w ADHD have decreased activity of the PFC and increasing
DA allows for increasing attention
Worldwide use of methylphenidate
- Almost w/out exception, the rate of methylphenidate use is increasing worldwide
Lecture 10 - Autism Part 1
Intro - historical
- Leo Kanner - early infantile autism
- Hans Asperger
The autism spectrum
- Aspergers in autism spectrum
- Numerical grade based on functional impairment
- Behavioural and neurobiological traits represent one extreme of the spectrum
- Prevalence may be as high as 1 in every 500 births. ASD as a whole have prevalence
of 1 in every 110 births
Clinical description
- ASD Appears in early childhood, often recognized around ge 2
- Characterized by 3 major areas of difficulty:
- Impaired communication
- Impaired social interactions
- Restricted behaviour
1. Impaired communication
- Absent or delays in communication
- Unusual patterns of communication
- Echolalia: repeating the speech and intonation of others - is common
Lecture 9 - ADHD
Ino to ADHD
- attention -deficit/hyperactivity disorder (ADHD)
- Developmental disorder
- Essential feature is pattern of inattention and/or hyperactivity-impulsivity
- Hyperactivity: excessive motor activity at inappropriate times
- Impulsivity: doing w/out thinking, not considering consequences
ADD vs ADHD
- According to latest DSM-5 ADD not a diagnosis
- Now ADHD w/out the hyperactive
Key features of ADHD
- Need to demonstrate consistent inattentiveness and hyperactivity, at school home, and
peer related engagements
- Context matters
- ADHD creates other problems in child’s life
- Academic performance suffers
- Social rejection
- Not intellectual disorder, but can impact grades due to inattentiveness
Prevalence of ADHD
- 7.2% worldwide
- Adult, 2.5%
- Diagnostic criteria can vary between studies
- Cultural context
- Most DSM-5 criteria based on elementary school boys in north America
Comorbidity of ADHD
- Only about ⅓ children are diagnosed w ADHD alone.majority are diagnosed w at least
one other DSM disorder
Genetics of ADHD
- Highest genetic loading
- Most successfully treated
- Elevated in first-degree biological relatives of individuals with ADHD
- Etiology of ADHD has been suggested to e up to 80% genetic
- Potentials environmental/developmental factors
- Specific mutation in dopamine reuptake transporter (DAT1) more likely to
exhibit symptoms of ADHD in children whose mothers smoked during pregnancy
- Perinatal hypoxia- temporary shortage of oxygen around time of birth - been
linked to development of ADHD
- No convincing evidence that artificial food dye can cause ADHD
- No evidence ADHD can be caused by sugar
Behavioural markers of ADHD
- Children w ADHD will usually opt for immediate reward in psychological studies
, - Rewards apparently have less of an influence over the behaviour of children with ADHD
- Children with ADHD impaired performance in go-no-go task
- Some evidence showing that children with ADHD take more risks in gambling
experiments
- Seems children with ADHD makes risky and impulsive decisions (frontal lobe and
dopamine sys impairment)
- Dual pathway model
Neuroimaging findings in ADHD
- Reduced grey matter in prefrontal cortex, striatum, cerebellum and corpus callosum
Treatment of ADHD
- Pharmacological treated options very effective
- Psychostimulant variety of drugs most common for ADHD treatment
- Popular drugs include methylphenidate (Ritalin/concerta), amphetamine (adderal)
and d-amphetamine (dexedrine)
How do ADHD medications work?
- Amphetamines all generally work through similar mechanisms to boat dopamine and
norepinephrine signaling
- Theory is that individuals w ADHD have decreased activity of the PFC and increasing
DA allows for increasing attention
Worldwide use of methylphenidate
- Almost w/out exception, the rate of methylphenidate use is increasing worldwide
Lecture 10 - Autism Part 1
Intro - historical
- Leo Kanner - early infantile autism
- Hans Asperger
The autism spectrum
- Aspergers in autism spectrum
- Numerical grade based on functional impairment
- Behavioural and neurobiological traits represent one extreme of the spectrum
- Prevalence may be as high as 1 in every 500 births. ASD as a whole have prevalence
of 1 in every 110 births
Clinical description
- ASD Appears in early childhood, often recognized around ge 2
- Characterized by 3 major areas of difficulty:
- Impaired communication
- Impaired social interactions
- Restricted behaviour
1. Impaired communication
- Absent or delays in communication
- Unusual patterns of communication
- Echolalia: repeating the speech and intonation of others - is common
