Abstract：
BACKGROUND:Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BPD) are frequently comorbid and overlapping diagnoses. To move beyond diagnosis toward unique pathophysiology, we evaluated both ADHD and BPD children for neurologic examination abnormalities (NEAs) in comparison with normal control (NC) children. METHODS:We performed the Revised Physical and Neurological Examination for Soft Signs in three groups (ADHD, BPD, NC). Then, a rater blind to diagnosis evaluated their motor performance. Results were analyzed with a multiple analysis of covariance. RESULTS:Subjects with ADHD were impaired on repetitive task reaction time. In contrast, pediatric BPD subjects, both with and without comorbid ADHD, were impaired on sequential task reaction time. CONCLUSIONS:This differential pattern of NEAs by diagnosis suggests pathophysiologic differences between ADHD and BPD in children. Repetitive motor performance requires inhibition of nonrelevant movements; ADHD subjects' impairment in this domain supports the hypothesis that ADHD involves a core deficit of fronto-striato-basal ganglia neurocircuitry. In contrast, BPD subjects' impaired sequential motor performance is consistent with behavioral data showing impaired attentional set-shifting and reversal learning in BPD subjects. Further study, going beyond symptom description to determine pathophysiologic differences, is required to refine neuronal models of these often comorbid diagnoses.
journal_name
Biol Psychiatryjournal_title
Biological psychiatryauthors
Dickstein DP,Garvey M,Pradella AG,Greenstein DK,Sharp WS,Castellanos FX,Pine DS,Leibenluft Edoi
10.1016/j.biopsych.2004.12.010subject
Has Abstractpub_date
2005-10-01 00:00:00pages
517-24issue
7eissn
0006-3223issn
1873-2402pii
S0006-3223(04)01314-9journal_volume
58pub_type
临床试验,杂志文章abstract：:A high incidence of behavioral and learning difficulties has been found in juvenile seizure-prone baboons presented with a graded series of operant behavioral task challenges. The animals fell into two distinct groups based upon the rate at which their operant performance was able to develop, the amount of day-to-day ...
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journal_title：Biological psychiatry
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journal_title：Biological psychiatry
pub_type： 杂志文章,评审
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journal_title：Biological psychiatry
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journal_title：Biological psychiatry
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：1996-09-01 00:00:00
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journal_title：Biological psychiatry
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Biological psychiatry
pub_type： 临床试验,杂志文章
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journal_title：Biological psychiatry
pub_type： 临床试验,杂志文章
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journal_title：Biological psychiatry
pub_type： 杂志文章
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更新日期：2009-12-01 00:00:00
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journal_title：Biological psychiatry
pub_type： 杂志文章,评审
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更新日期：2016-01-01 00:00:00
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journal_title：Biological psychiatry
pub_type： 临床试验,杂志文章
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更新日期：2004-10-15 00:00:00
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journal_title：Biological psychiatry
pub_type： 杂志文章,评审
doi：10.1016/j.biopsych.2005.06.027
更新日期：2006-02-01 00:00:00
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journal_title：Biological psychiatry
pub_type： 杂志文章
doi：10.1016/j.biopsych.2006.04.024
更新日期：2006-09-15 00:00:00
