Objective: Aerobic exercise may be associated with changes in brain activity within the default mode network (DMN) and dorsal attention network (DAN). We hypothesized that changes in functional connectivity (FC) within the DMN and DAN might be most effectively activated by moderate-intensity exercise. Methods: Resting-state functional magnetic resonance imaging scans and visuospatial attention tests after resting were performed before and after each of moderate- and high-intensity aerobic exercises (10 min each) in 15 healthy male volunteers. Results: The reaction time during the attention test increased significantly, and the rate of correct responses decreased from moderate-intensity exercise condition to high-intensity exercise condition. FC within the DMN under high-intensity exercise condition was higher than that under pre-exercise and moderate-intensity exercise conditions. FC within the DAN under moderate-intensity exercise condition was the highest, whereas FC between the DMN and DAN under moderate-intensity exercise condition was the lowest. Changes in cognitive domain functions were associated with changes in FC between the DMN and DAN. Conclusion Our results support the inverted-U hypothesis of maximum arousal efficacy during moderate exercise. Both cognitive domains, namely, the attention system and brain activity domains, may be better under moderate-intensity exercise than under high-intensity exercise.

Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two boardcertified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

Objective: Most affective neuroscience studies use pictures from the International Affective Picture System or standard facial expressions to elicit emotional experiences. The attention system, including the prefrontal cortex, can mediate emotional regulation in response to stimulation with emotional faces. We hypothesized that emotional experience is associated with brain activity within the neocortex. In addition, modification within the neocortex may be associated with brain activity within the attention system. Methods: Thirty-one healthy adult participants were recruited to be assessed for emotional expression using clinical scales of happiness, sadness, anxiety, and anger as and for emotional experience using brain activity in response to pictures of facial emotional expressions. The attention system was assessed using brain activity in response to the go-no-go task. Results: We found that emotional experience was associated with brain activity within the frontotemporal cortices, while emotional expression was associated with brain activity within the temporal and insular cortices. In addition, the association of brain activity between emotional experiences and expressions of sadness and anxiety was affected by brain activity within the anterior cingulate gyrus in response to the go-no-go task. Conclusion Emotional expression may be associated with brain activity within the temporal cortex, whereas emotional experience may be associated with brain activity within the frontotemporal cortices. In addition, the attention system may interfere with the connection between emotional expression and experience.

Objective: Facial affect recognition is associated with neuropsychological status and psychiatric diseases. We hypothesized that facial affect recognition is associated with psychological status and perception of other affects. Methods: A total of 80 images depicting facial affect, including 20 Neutral, 20 Angry, 20 Fear, and 20 Sad, were screened for use in our research. A total of 100 healthy individuals were asked to rate these images using a 10-point Likert scale and complete psychological scales assessing the emotional statuses and cognitive functions. Results: The participants’ emotional state of aggression, attention, and impulsivity may have been associated with their interpretation of the Angry facial expressions. The participants often rated the Angry facial expressions as Fear. The participants rated Fear images as Angry or Sad. In response to a Sad facial expression, the participants reported psychological statuses of attention and impulsivity which were associated with the facial expression rating. The participants rated the Sad expression as Angry or Fear. Conclusion The psychological statuses of the participants were significantly correlated with their interpretation of facial affects. In particular, a psychological state of attention was often correlated with incorrect affect ratings. Attention and impulsivity could affect the rating of the sad facial expressions.

Objective: During the coronavirus disease (COVID-19) pandemic, several studies have found that Internet usage and gaming times have increased among adolescents. Parents’ Internet literacy and attitudes toward Internet gaming have been reported to affect children’s Internet gaming disorder (IGD). We hypothesized that parents’ attitudes toward Internet use and gaming would affect the prevalence of IGD among adolescents. Methods: A total of 199 mothers of children who played Internet games were surveyed online to gather information regarding their demographic characteristics, children’s Internet use patterns, psychological factors, and Internet gaming literacy. Results: Among adolescents, increased Internet usage or gaming time was not associated with IGD, but the presence of attention deficit hyperactivity disorder (ADHD) was. Among parents, anxiety, depression, and family togetherness were not related to IGD, but a positive perception of gaming protected against the development of IGD, whereas a negative perception was a risk factor for IGD. Conclusion Increased gaming time neither causes nor correlates with IGD in adolescents, even though ADHD may be a risk factor for IGD. Parents’ positive or negative perceptions of gaming can be protective or present a risk factor, respectively, for their children’s development of IGD.

Objectives: Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. Methods: The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. Results: According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners’ Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. Conclusion The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

Objectives: Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. Methods: The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. Results: According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners’ Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. Conclusion The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

Objective: We sought to determine if the links between and within the default mode network (DMN) and dorsal attention network (DAT) exhibited different conditions according to catechol-O-methyltransferase (COMT) gene polymorphism in relationship to attention-deficit hyperactivity disorder (ADHD) symptoms. Methods: Fifty-seven children with ADHD and 48 healthy controls (HCs) were administered an intelligence test, the Children’s Depression Inventory, the Korean ADHD rating scale, and continuous performance test. Resting-state brain functional MRI scans were obtained, and COMT genotyping was performed to distinguish valine carriers and methionine homozygotes. Results: Compared to controls, children with ADHD showed increased ADHD scale scores, increased visual commission errors, and increased functional connectivity (FC) within the DMN and DAT. Compared to all children with ADHD, children with the methionine homozygote and those who were valine carriers showed increased FC within the DMN and DAT and decreased FC between the DMN and DAT. FC within the DMN was also increased in HC valine carriers compared to HC children with the methionine homozygote, and in children with ADHD who were valine carriers compared to HC valine carriers. Conclusion We observed increased brain connectivity within the DMN and DAT and altered brain connectivity within and between the DMN and DAT associated with COMT polymorphism in children with ADHD.

BACKGROUND: Studying immigrants may have the potential to explore how cultural and environmental changes affect the internet game play patterns of individuals in the two countries. We planned to compare risk and preventive factors for Internet Gaming Disorder (IGD) between Korean adolescents in Korea and immigrant Koreans in the US. METHODS: Ninety-four Koreans and 133 immigrant Koreans were recruited. Independent factors consisted of five domains including demographic data, physical activity, academic, art, and music activities, psychological factors, and game and media play. The dependent variable in the current study was the high-risk group of IGD, which was assessed with Young’s Internet Addiction Scale scores. To determine the protective and risk factors for IGD, we performed a multiple logistic regression analysis using the high-risk group as the dependent variable. RESULTS: Five domains affected the risk for IGD in Korean and immigrant Korean groups. Vigorous physical activity was the strongest protective factor for IGD in the Korean group, while media activity was the strongest protective factor for IGD in immigrant Koreans in the US. CONCLUSION: The results indicate that internet gaming problems might be affected by environmental factors and it is recommended that gaming activity is substituted with physical activity, extracurricular classes, books, and music.
Adolescent ; Emigrants and Immigrants ; Humans ; Immunoglobulin D ; Internet ; Korea ; Logistic Models ; Motor Activity ; Music ; Protective Factors ; Psychology ; Risk Factors ; United States

OBJECTIVE: We aimed to assess disturbances in postural and gait balance and functional connectivity within the brain regions controlling balance in children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Thirteen children with ADHD and 13 age- and sex-matched controls were recruited. Gait balance was assessed by the difference in the center of pressure (COP) between the left and right foot, as well as the difference in plantar pressure between the left and right foot during gait. Neuroimaging data were acquired using a 3.0 Tesla MRI scanner. Functional connectivity between the vermis of the cerebellum and all other brain regionswas assessed. RESULTS: The difference in plantar pressure between the left foot and right foot in the ADHD group was greater than that observed in the control group. The average COP jerk score of the right foot in the ADHD group was higher than that observed in the control group. A higher functional connectivity between the cerebellum and the right middle frontal gyrus (premotor cortex) and medial frontal gyrus (cingulate gyrus) was observed in the control group relative to the ADHD group. In the ADHD group, the difference in plantar pressure between the left and right foot was also negatively correlated with the beta-value within the middle frontal gyrus. CONCLUSION: Children with ADHD had disturbance of balance as assessed by plantar pressure. Decreased brain connectivity from the cerebellum to the premotor cortex and anterior cingulate was associated with disturbances of posture and balance in children with ADHD.
Brain* ; Cerebellum ; Child* ; Foot ; Gait ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging ; Motor Cortex ; Neuroimaging ; Posture ; Prefrontal Cortex