Objective:To investigate the characteristics of cortical morphology in children with attention defi-cit hyperactivity disorder(ADHD)and those with oppositional defiant disorder(ODD)from both categorical and dimensional analyses.Methods:A total of 72 children were enrolled,including 16 children with ADHD and ODD,20 children with ADHD without ODD,and 36 age-gender-matched normal children.The diagnoses were made ac-cording to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)criteria.The Chi-nese Wechsler Intelligence Scale for Children(C-WISC)was used to access intelligence quotient.All subjects par-ticipated in the magnetic resonance imaging(MRI)scan.The features of cortical morphology were determined using FreeSurfer software.Results:Children with ADHD and ODD[(6 528.1±857.5)mm3 vs.(7 591.2±657.3)]and children with ADHD only[(6 867.2±41.3)mm3 vs.(7 591.2±657.3)mm3]had smaller volume in the left later-al superior temporal gyrus(P＜0.05)than controls.No difference was found between ADHD with ODD group and ADHD without ODD group.There was no correlation between the cortical volume of left lateral superior temporal gyrus and ODD symptoms.Conclusion:The reduced cortical volume of left lateral superior temporal gyrus may be an important indication of the abnormal brain structure of ADHD in children.And comorbid status of ODD dose not change this structural variation.

Objective:To analyze the neurocognitive abnormalities and related emotional and behavioral problems in 410 adolescent patients with Turner syndrome (TS) managed in Henan Children′s Hospital in the past 5 years, and to explore the relationship between neurocognitive abnormalities and chromosome karyotype, pubertal development, hormone replacement therapy.Methods:A retrospective case series study.A total of 410 adolescent patients who were diagnosed with TS by karyotype or fluorescence in situ hybridization in the outpatient or inpatient Department of Endocrinology, Genetics and Metabolism at Henan Children′s Hospital from June 2018 to June 2023 were selected and divided into 2 groups according to age: < 12 years old and 12-18 years old.Neurocognitive assessments were performed based on the results of the Wechsler Intelligence Scale (4 th edition) for children and behavior scales for children, SPSS 22.0 software was used for data processing and statistical analysis, and chi-square test was used to analyze the correlation between chromosome karyotype, intelligence development level, pubertal development status, hormone therapy status and the occurrence of neuropsychiatric diseases. Results:Among the 410 TS patients, 207 cases had the karyotype of 45, X0/46, XX, accounting for 50.49%, 94 cases had the monosomic karyotype of 45, X0, accounting for 22.93%.Forty-six patients completed the Wechsler intelligence test, with the intelligence quotient (IQ) score ranging from 70 to 105, with high verbal comprehension and perceptual reasoning scores and low processing speed and working memory scores on all assessments.Fifty-two patients completed the hyperactivity scale assessment, and 43 cases had a predisposition to attention deficit hyperactivity disorder (ADHD).There were no significant differences in total IQ, perceptual reasoning and processing speed among the children with karyotype 45, X0, chimeric, and X chromosome structural abnormalities ( H=3.161, 1.955, 5.890, all P>0.05), while there were significant differences in verbal comprehension and working memory among the three groups ( H=7.697, 9.694, all P<0.05).Among TS patients 12-18 years old, 68 cases completed the depression scale self-assessment, of which 23 cases had depressive tendencies.There was no correlation between depressive tendency and chromosome karyotype, pubertal development and hormone replacement therapy ( P>0.05). Conclusions:TS patients generally have low intelligence levels and tend to have ADHD in childhood.TS patients in the pubertal development have a high incidence of depression.Pubertal development status and hormone replacement therapy show no correlation with the occurrence of neuropsychiatric diseases in TS patients.

To analyze the differences in cerebral blood flow (CBF) characteristics among children with different subtypes of attention deficit and hyperactivity disorder (ADHD) and their relationship with executive function using arterial spin labeling (ASL) technology.

Objective:To explore the characteristics of parental emotional regulation(ER)and its influence on the ER of children with attention deficit hyperactivity disorder(ADHD).Methods:A total of 140 children with ADHD meeting the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)criteria and their parents,68 normal controls and their parents were recruited.ER was assessed using the Difficulties in Emotion Regulation Scale(DERS),Emotion Regulation Questionnaire(ERQ)and Emotion Regulation Checklist(ERC).Re-sults:Higher scores of DERS in emotion regulation strategies,impulse control and goal-directed behavior were found in parents of children with ADHD compared with parents of normal controls(Ps＜0.05).The higher emo-tional lability(EL)of ERC and lower ER of ERC detected in children with ADHD were correlated with the emo-tion regulation strategies,impulse control and goal-directed behavior of their parents(Ps＜0.01).The mediation an-alyses suggested that ER in children with ADHD may mediate the relationship of parental emotion regulation strate-gies and parental impulse control with children's EL.Conclusion:Parents of children with ADHD may exhibit emo-tional dysregulation in multiple subdimensions which might affect emotional regulation and aggravate the emotional lability of children with ADHD.

Objective:To explore the characteristics of delay discounting and non-systematic response data in intertemporal choice of adults with attention deficit hyperactivity disorder(ADHD),and to explore the best data processing strategy for delay discounting task.Methods:Totally 108 adults with ADHD meeting the diagnostic cri-teria of the Diagnostic and Statistical Manual of Mental Health Disorder,Fifth Edition(DSM-5)and 87 gender matched normal controls were enrolled.ADHD symptoms were assessed using the ADHD Symptom Rating Scale,the delay discounting task was used to measure the delay discounting rate,and a model-free algorithm was used to i-dentify non-systematic response data.Results:There was no significant difference in the proportion of non-systemat-ic response data between ADHD group and normal control group(P＞0.05).In the data sets using different data screening strategies,the delay discounting rates were higher in the ADHD group than in the normal control group(Ps＜0.05).The delay discounting rates were positively correlated with the hyperactive impulse scores(r=0.24,P=0.001),the inattention scores(r=0.20,P＜0.01)and the total scores of ADHD symptom Rating Scale(r=0.22,P＜0.01).Conclusion:Adults with ADHD prefer to obtain immediate small rewards in intertemporal choice.The immediate preference of intertemporal choice may be mainly related to hyperactive impulsive symp-toms.Exclusion strategy of non-systematic response data may be more applicable to delay discount task research.

Objective: Attention deficit hyperactivity disorder (ADHD) is a polygenic neurodevelopmental disorder with significant gender differences. The sexual dimorphism of ADHD may be associated with estrogen acting through estrogen receptors (ESR). This study investigates the impact of ESR gene polymorphism and its interactions with neurodevelopmental genes on ADHD susceptibility. Methods: The study compared genotyping data of single nucleotide polymorphisms in ESR1 and ESR2 in 1,035 ADHD cases and 962 controls. The gene-gene interactions between ESR genes and three neurodevelopmental genes (brain-derived neurotrophic factor [BDNF], synaptosomal-associated protein of 25 kDa gene [SNAP25], and cadherin-13 [CDH13]) in ADHD were investigated using generalized multifactor dimensionality reduction and verified by logistic regression analysis. Results: The G allele of rs960070/ESR2 (empirical p=0.0076) and the A allele of rs8017441/ESR2 (empirical p=0.0426) were found significantly higher in ADHD cases than in the controls but not in male or female subgroups. Though no difference was found in all subjects or females, the A allele of rs9340817/ESR1 (empirical p=0.0344) was found significantly higher in ADHD cases than controls in males. We also found genetic interaction models between ESR2 gene, neurodevelopmental genes and ADHD susceptibility in males (ESR2 rs960070/BDNF rs6265/BDNF rs2049046/SNAP25 rs362987/CDH13 rs6565113) and females (ESR2 rs960070/BDNF rs6265/BDNF rs2049046) separately, though it was negative in overall subjects. Conclusion The ESR gene polymorphism associates with ADHD among Chinese Han children, with interactions between ESR genes and neurodevelopmental genes potentially influencing the susceptibility of ADHD.

Objective: Subthreshold attention-deficit/hyperactivity disorder (ADHD) has been suggested to be a “morbid condition” which also needs medical attention. Methods: The present study recruited 89 children with subthreshold ADHD (sADHD), 115 children with diagnosed ADHD (cADHD), and 79 healthy controls (HC) to explore the clinical manifestation, executive functions (EFs) of sADHD, and the caregiver strain. The clinical manifestation was evaluated through clinical interviews and parent-reports. Executive functions were assessed both experimentally and ecologically. Caregiver strain was measured by a parent-reported questionnaire. Results: For the clinical manifestation, both sADHD and cADHD indicated impairments when compared with HC. The comorbidities and the scaled symptoms indicated that the externalizing behaviors were relatively less serious in sADHD than cADHD, whereas the internalizing behaviors between two groups were comparable. For ecological EFs, sADHD scored between cADHD and HC in inhibition and working memory. For experimental EFs, sADHD was comparable to cADHD in inhibition, shifting, and was worse than cADHD in verbal working memory. For the caregiver strain, all scores of sADHD were between that in cADHD and that in HC. Conclusion Our present findings supported the suggestion of subthreshold ADHD as “morbid condition,” which should be treated with caution in clinical practice, especially for the internalizing behaviors and some key components of EFs.

Objective:To observe the clinical effect of helmet therapy in cranial remodeling of infants with deformational plagiocephaly.Methods:A total of 114 infants with plagiocephaly received helmet therapy at the age of 4 to 12 months over the period from 2016 to 2018 and the results were analyzed retrospectively. Seventy-four were male and forty female. The average ages were (7.49±1.91) and (7.54±2.10) months, respectively. A Spectra scanner was used to quantify each head′s radial symmetry index (RSI), cranial vault asymmetry (CVA) and cranial vault asymmetry index (CVAI) before and after 100 days of treatment, and those data were related with age (4-6 months, 7-9 months and 10-12 months), gender and severity of deformity (levels III-V).Results:The average RSI, CVA and CVAI improved significantly for all of the infants studied. The average RSI, CVA and CVAI improved the most for those 4-6 months old. Those with level-IV deformity showed significantly better improvement than those with level III or V deformity.Conclusions:Helmet therapy is an effective way to improve deformities due to plagiocephaly among infants. The best age for treatment is 4-6 months. Patients with less malformation are more easily corrected.

Family environment plays an important part of the occurrence,development and outcome of attention-deficit/hyperactivity disorder (ADHD).Family and parenting interventions focus on the inter environment,aiming at forming an effective behavioral management,a better communication strategy,which will be conductive for child's symptoms as well as functions.Parents'emotion and self-efficacy as well as family functioning will be affected also.Common family and parenting skills include parent training and systematic family therapy,which respectively focus on behavior management and the whole family in view of system.The Multimodal Treatment Study of Children with ADHD (MTA) may have potential effects compared with single medical treatment and behavioral treatment.In China,parent training and structural family therapy have been proved to be effective.However,further consideration and experiments are necessary,especially on the long-time ending and individual management.

Objective:To explore the characteristics of attention during visual search tasks in adults with attention-deficit/hyperactivity disorder (ADHD).Methods:Totally 45 adult patients with ADHD who met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-IV) and 44 healthy controls matched with age,gender and IQ were selected.The reaction time and accuracy rate of two groups were compared under visual search tasks of low and high visual working memory load.Results:The reaction time was longer in patients with ADHD than in the healthy controls in both low-load task [(823 ± 144) ms vs.(754 ± 123) ms,P ＜ 0.01] and highload task [(912 ± 163) ms vs.(851 ± 162) ms,P ＜ 0.01].Compared with the performance in low load task,the search reaction time was longer in high load task [ADHD group:(823 ± 144) ms vs.(912 ± 163) ms,P ＜ 0.01;control group:(754 ± 123) ms vs.(851 ± 162) ms,P ＜0.01] and the accuracy rate was lower during high load task than low load task[ADHD group:(95.9 ±4.3)％ vs.(91.2 ± 14.29)％;control group:(95.8 ± 4.2)％ vs.(94.4 ±4.9) ％,P ＜ 0.01] in both ADHD and control groups.Conclusion:The results suggest impairment in top-down attentional control in ADHD adults.When the visual working memory load is increasing,ADHD patients allocate more working memory resources on storing the target representation and less resources on visual attention,so the search efficiency may be influenced.