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Gender specific differences in auditory brain stem response in young patients with ADHD
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P.7.b. Child and adolescent disorders and treatment − Disorders (clinical)
assess for ASD, ADHD, mood, anxiety, and disruptive behavior disorders, emotional dysregulation, and impaired social and school functioning. These results provide further support for the clinical relevance of ATs irrespective of referral status. References [1] Grzadzinski, R., Di Martino, A., Brady, E., Mairena, M.A., O’Neale, M., Petkova, E, et al., 2011. Examining autistic traits in children with ADHD: does the autism spectrum extend to ADHD? J Autism Dev Disord 41(9):1178−91. [2] Kochhar, P., Batty, M.J., Liddle, E.B., Groom, M.J., Scerif, G., Liddle, P.F., et al., 2011. Autistic spectrum disorder traits in children with attention deficit hyperactivity disorder. Child Care Health Dev 37(1):103−10. [3] Mulligan, A., Anney, R.J., O’Regan, M., Chen, W., Butler, L., Fitzgerald, M., et al., 2009. Autism symptoms in Attention-Deficit/ Hyperactivity Disorder: a familial trait which correlates with conduct, oppositional defiant, language and motor disorders. J Autism Dev Disord 39(2):197–209. Epub 2008/07/22. [4] Kotte, A., Joshi, G., Fried, R., Uchida, M., Spencer, A., Woodworth, K.Y., et al., 2013. Autistic traits in children with and without ADHD. Pediatrics 132(3):e612−22. [5] Biederman, J., Petty, C.R., Fried, R., Wozniak, J., Micco, J.A., Henin, A., et al., 2010 Child behavior checklist clinical scales discriminate referred youth with autism spectrum disorder: a preliminary study. J Dev Behav Pediatr 31(6):485−90. Disclosure statement: Dr. Joseph Biederman is currently receiving research support from the following sources: The Department of Defense, Food & Drug Administration, Lundbeck, Merck, Neurocentria Inc., PamLab, Pfizer, Shire Pharmaceuticals Inc., SPRITES, Sunovion, and NIH. In 2016, Dr. Biederman received honoraria from the MGH Psychiatry Academy for tuitionfunded CME courses, and from Avekshan, Alcobra and AACAP. He has a US Patent Application pending (Provisional Number #61/233,686) through MGH corporate licensing, on a method to prevent stimulant abuse. In 2015, Dr. Biederman received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses, and from Avekshan. He received research support from Ironshore, Magceutics Inc., and Vaya Pharma/Enzymotec. This work was supported by NIH grants R01MH050657 and R01HD036317 (JB), and by the Pediatric Psychopharmacology Research Council Fund.
P.7.b.005 Gender specific differences in auditory brain stem response in young patients with ADHD E. Claesdotter-Hybbinette1 ° , M. Cervin1 , S. Akerlund1 , M. R˚astam1 , M. Lindvall1 1 Dept of Clinical Sciences, Lund University, Lund, Sweden Objective: The auditory brainstem response (ABR) is often affected in neurodevelopmental disorders [1−3]. The aim of this study was to investigate possible gender differences in ABR between young females and young males with ADHD, compared to control subjects.
Method: We studied 63 females with ADHD (mean 13.8 years, SD 2.5), 26 female controls (mean 13.8 years, SD 2.7), 48 males with ADHD (mean 13.1 years, SD 1.8), and 20 male controls (mean 12.8 years, SD 1.7). All patients were diagnosed according to the DSM-IV. The ABR consists of seven positive peaks (wave I–VII) that occur 10 ms following a stimulus recorded by five electrodes; one reference electrodes on the mastoid processes of each ear and two active electrodes and one ground electrode placed on the forehead. Results: Comparing the ABR of 63 girls with ADHD to 26 age correlated control subjects 3 traits were identified, denoted TR6, TR14 and TR15. The higher value in TR6 (p = 0.000064), is explained by more aberrant curve profiles in the thalamic region. In TR14, the aberration was found in a region from superior olivary complex to thalamus (p = 0.00059). TR15 (p = 0.00035), is explained by more aberrant curve profiles in the lateral leminiscus. When looking at the ABR from 48 young males with ADHD and comparing them to 20 age correlated control subjects, we found 3 traits; TR4, TR5 and TR14. TR 4 is a lower correlation to a norm curve in inferior colliculus and thalamic area (p = 0.00105). TR5 identifies irregular curve profiles representing the nucleus cochlea (p = 0.00027). TR14, is described as an aberration in superior olivary complex to thalamus (p = 0.00013). Conclusion: These data indicate both gender specific aberrations in the ABR in ADHD subjects as well as specific response differences between ADHD subjects and normal controls. Young females with ADHD exhibited a significantly different ABR in a region between cochlear nucleus and superior olivary complex and in the thalamic region. Neither of these differences could be seen in the male ADHD group when compared to the male control subjects. However, in the male ADHD group ABR aberrancy was found in the midbrain region and in the more peripheral part; nucleus cocleus. Only one trait was different for both male and females between the ADHD group and the control subjects. The present study suggests that the ABR method might provide useful biomarkers to support the clinical diagnoses of ADHD. Further studies of ABR and other child and adolescent disorders such as Autism and OCD are in progress. References [1] Wong, V., Wong, S.N., 1991. Brainstem auditory evoked potential study in children with autistic disorder. J. Autism Dev. Disord. 21 (3), 329−40. [2] Schochat, E., Scheuer, CI., Andrade, E.R. 2002 ABR and auditory P300 findings in children with ADHD. Arq. Neuropsiquiatr. (60) 742–747. [3] Claesdotter-Hybbinette, E., Safdarzadeh-Haghighi, M., Rastam, M., Lindvall, M., 2015 Abnormal brainstem auditory response in young females with ADHD. Psychiatry Res. 08 229(3).
Table 1 (abstract P.7.b.005). ABR results for young patients with ADHD compared to controls. Trait
TR4 TR5 TR6 TR14 TR15
Females mean (S.D.); median ADHD (N = 63)
Controls (N = 26)
0.62 (0.29); 0.71 0.85 (0.14); 0.90 172 (56); 174 3.8 (1.8); 4 66 (47); 61
0.73 (0.19); 0.81 0.85 (0.22); 0.94 116 (49); 123 2.2 (1.9); 2 31 (24); 27
Mann–Whitney U test was used.
p-value
0.084 0.321 0.000064 0.00059 0.00035
Males mean (S.D.); median ADHD (N = 48)
Controls (N = 20)
0.57(0.26); 0.62 0.80 (0.18); 0.87 157 (63); 156 4.5 (1.8); 5 57 (42); 52
0.77 (0.18); 0.80 0.93 (0.06); 0.95 139 (64); 122 2.3 (1.8); 2 47 (34); 39
p-value
0.00105 0.00027 0.208 0.00013 0.518
P.7.b. Child and adolescent disorders and treatment − Disorders (clinical)
assess for ASD, ADHD, mood, anxiety, and disruptive behavior disorders, emotional dysregulation, and impaired social and school functioning. These results provide further support for the clinical relevance of ATs irrespective of referral status. References [1] Grzadzinski, R., Di Martino, A., Brady, E., Mairena, M.A., O’Neale, M., Petkova, E, et al., 2011. Examining autistic traits in children with ADHD: does the autism spectrum extend to ADHD? J Autism Dev Disord 41(9):1178−91. [2] Kochhar, P., Batty, M.J., Liddle, E.B., Groom, M.J., Scerif, G., Liddle, P.F., et al., 2011. Autistic spectrum disorder traits in children with attention deficit hyperactivity disorder. Child Care Health Dev 37(1):103−10. [3] Mulligan, A., Anney, R.J., O’Regan, M., Chen, W., Butler, L., Fitzgerald, M., et al., 2009. Autism symptoms in Attention-Deficit/ Hyperactivity Disorder: a familial trait which correlates with conduct, oppositional defiant, language and motor disorders. J Autism Dev Disord 39(2):197–209. Epub 2008/07/22. [4] Kotte, A., Joshi, G., Fried, R., Uchida, M., Spencer, A., Woodworth, K.Y., et al., 2013. Autistic traits in children with and without ADHD. Pediatrics 132(3):e612−22. [5] Biederman, J., Petty, C.R., Fried, R., Wozniak, J., Micco, J.A., Henin, A., et al., 2010 Child behavior checklist clinical scales discriminate referred youth with autism spectrum disorder: a preliminary study. J Dev Behav Pediatr 31(6):485−90. Disclosure statement: Dr. Joseph Biederman is currently receiving research support from the following sources: The Department of Defense, Food & Drug Administration, Lundbeck, Merck, Neurocentria Inc., PamLab, Pfizer, Shire Pharmaceuticals Inc., SPRITES, Sunovion, and NIH. In 2016, Dr. Biederman received honoraria from the MGH Psychiatry Academy for tuitionfunded CME courses, and from Avekshan, Alcobra and AACAP. He has a US Patent Application pending (Provisional Number #61/233,686) through MGH corporate licensing, on a method to prevent stimulant abuse. In 2015, Dr. Biederman received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses, and from Avekshan. He received research support from Ironshore, Magceutics Inc., and Vaya Pharma/Enzymotec. This work was supported by NIH grants R01MH050657 and R01HD036317 (JB), and by the Pediatric Psychopharmacology Research Council Fund.
P.7.b.005 Gender specific differences in auditory brain stem response in young patients with ADHD E. Claesdotter-Hybbinette1 ° , M. Cervin1 , S. Akerlund1 , M. R˚astam1 , M. Lindvall1 1 Dept of Clinical Sciences, Lund University, Lund, Sweden Objective: The auditory brainstem response (ABR) is often affected in neurodevelopmental disorders [1−3]. The aim of this study was to investigate possible gender differences in ABR between young females and young males with ADHD, compared to control subjects.
Method: We studied 63 females with ADHD (mean 13.8 years, SD 2.5), 26 female controls (mean 13.8 years, SD 2.7), 48 males with ADHD (mean 13.1 years, SD 1.8), and 20 male controls (mean 12.8 years, SD 1.7). All patients were diagnosed according to the DSM-IV. The ABR consists of seven positive peaks (wave I–VII) that occur 10 ms following a stimulus recorded by five electrodes; one reference electrodes on the mastoid processes of each ear and two active electrodes and one ground electrode placed on the forehead. Results: Comparing the ABR of 63 girls with ADHD to 26 age correlated control subjects 3 traits were identified, denoted TR6, TR14 and TR15. The higher value in TR6 (p = 0.000064), is explained by more aberrant curve profiles in the thalamic region. In TR14, the aberration was found in a region from superior olivary complex to thalamus (p = 0.00059). TR15 (p = 0.00035), is explained by more aberrant curve profiles in the lateral leminiscus. When looking at the ABR from 48 young males with ADHD and comparing them to 20 age correlated control subjects, we found 3 traits; TR4, TR5 and TR14. TR 4 is a lower correlation to a norm curve in inferior colliculus and thalamic area (p = 0.00105). TR5 identifies irregular curve profiles representing the nucleus cochlea (p = 0.00027). TR14, is described as an aberration in superior olivary complex to thalamus (p = 0.00013). Conclusion: These data indicate both gender specific aberrations in the ABR in ADHD subjects as well as specific response differences between ADHD subjects and normal controls. Young females with ADHD exhibited a significantly different ABR in a region between cochlear nucleus and superior olivary complex and in the thalamic region. Neither of these differences could be seen in the male ADHD group when compared to the male control subjects. However, in the male ADHD group ABR aberrancy was found in the midbrain region and in the more peripheral part; nucleus cocleus. Only one trait was different for both male and females between the ADHD group and the control subjects. The present study suggests that the ABR method might provide useful biomarkers to support the clinical diagnoses of ADHD. Further studies of ABR and other child and adolescent disorders such as Autism and OCD are in progress. References [1] Wong, V., Wong, S.N., 1991. Brainstem auditory evoked potential study in children with autistic disorder. J. Autism Dev. Disord. 21 (3), 329−40. [2] Schochat, E., Scheuer, CI., Andrade, E.R. 2002 ABR and auditory P300 findings in children with ADHD. Arq. Neuropsiquiatr. (60) 742–747. [3] Claesdotter-Hybbinette, E., Safdarzadeh-Haghighi, M., Rastam, M., Lindvall, M., 2015 Abnormal brainstem auditory response in young females with ADHD. Psychiatry Res. 08 229(3).
Table 1 (abstract P.7.b.005). ABR results for young patients with ADHD compared to controls. Trait
TR4 TR5 TR6 TR14 TR15
Females mean (S.D.); median ADHD (N = 63)
Controls (N = 26)
0.62 (0.29); 0.71 0.85 (0.14); 0.90 172 (56); 174 3.8 (1.8); 4 66 (47); 61
0.73 (0.19); 0.81 0.85 (0.22); 0.94 116 (49); 123 2.2 (1.9); 2 31 (24); 27
Mann–Whitney U test was used.
p-value
0.084 0.321 0.000064 0.00059 0.00035
Males mean (S.D.); median ADHD (N = 48)
Controls (N = 20)
0.57(0.26); 0.62 0.80 (0.18); 0.87 157 (63); 156 4.5 (1.8); 5 57 (42); 52
0.77 (0.18); 0.80 0.93 (0.06); 0.95 139 (64); 122 2.3 (1.8); 2 47 (34); 39
p-value
0.00105 0.00027 0.208 0.00013 0.518