Each title in this colorful series discusses an issue that either is part of students' lives or is likely affecting someone they know. Presenting multiple sides to current issues, each title distinguishes itself through its dedicated focus on concerns that today's middle and high school students deal with regularly, such as underage drinking and obesity.

Plus, the authors provide descriptive summaries of drug therapies that you can use to compare treatment symptoms of side effects, and determine appropriate dosages. A great way for busy physicians and pediatric caregivers to stay abreast of critical issues in ADHD from early childhood to adulthood.

Author: Marianne Mercugliano, Thomas J. Power, Nathan J. Blum
Paperback: 368 pages
Company: Brookes Publishing Company (1999-01)
ISBN: 1557663580
List Price: $39.95
Amazon Price: $29.99
Used Price: $0.22

Mothers of children with Attention Deficit Disorder must inevitably make decisions regarding their children's diagnosis within a context of competing discourses about the nature of the disorder and the legitimacy of its treatment. They also make these decisions within an overriding climate of mother-blame. Claudia Malacrida's Cold Comfort provides a contextualized study of how mothers negotiate with/against the 'helping professions' over assessment and treatment for their AD(H)D children.

Malacrida counters current conceptions about mothers of AD(H)D children (namely that mothers irresponsibly push for Ritalin to manage their children's behaviour) as well as professional assumptions of maternal pathology. This thought-provoking examination documents Malacrida's extensive interviews with mothers of affected children in both Canada and the United Kingdom, and details the way in which these women speak of their experiences. Malacrida compares their narratives to national discourses and practices, placing the complex mother-child and mother-professional relations at the centre of her critical inquiry.

Drawing on both poststructural discourse analysis and feminist standpoint theory, Malacrida makes a critical contribution to qualitative methodologies by developing a feminist discursive ethnography of the construction of AD(H)D in two divergent cultures. On a more personal level, she offers readers a moving, nuanced, and satisfying examination of real women and children facing both public and private challenges linked to AD(H)D.

A treasured parent resource since its publication, Taking Charge of ADHD provides authoritative information on ADHD and its treatment. From internationally renowned ADHD expert Russell A. Barkley, the book empowers parents by arming them with the knowledge, expert guidance, and confidence they need. Included are:

Based on the American Academy of Pediatrics’ current clinical practice guidelines for attention deficit/hyperactivity disorder (ADHD), this updated guide offers parents balanced, reassuring, and authoritative information on this challenging and often misunderstood condition. Written in clear, accessible language, the new edition features the latest information on ADHD medications and offers expanded sections on preschoolers and adolescents. A new chapter on advocacy, updates on special education services and laws, and the role of the medical home are also included. Among the common questions examined are How is ADHD diagnosed? What are today's best treatment options? and Will my child outgrow ADHD? The reference also addresses what schools can do to support children with the condition and offers ADHD management strategies that balance the roles of behavior therapy, medications, and parenting techniques.

This invaluable resource offers proven suggestions for: Engaging students' attention and active participation Keeping students on-task and productive Preventing and managing behavioral problems in the classroom Differentiating instruction and addressing students' diverse learning styles Building a partnership with parentsand much more.

Author: Sandra F. Rief M.A.
Paperback: 464 pages
Company: Jossey-Bass (2005-03-17)
ISBN: 0787972959
List Price: $32.95
Amazon Price: $17.09
Used Price: $12.47

Everyone knows someone with adult AD/HD. Yet we misattribute the symptoms to anxiety, depression, or even laziness, selfishness, or moodiness. Moreover, we assume AD/HD means "little boys with ants in their pants." In fact, childhood hyperactivity goes "underground" as the person matures, resulting in a mentally restless state. (By the way, the former, and still better-known, official term is ADD, plus or minus Hyperactivity. The new term, AD/HD, uses a slash mark to indicate that hyperactivity is not central to the diagnosis.)

Meticulously researched by award-winning journalist Gina Pera, Is It You, Me, or Adult A.D.D.? is a comprehensive guide to recognizing the behaviors where you least expect them (on the road and in the bedroom, for example) and developing compassion for couples wrestling with unrecognized ADHD symptoms. It also offers the latest information from top experts, plenty of real-life details, and easy-to-understand guidelines for finding the best treatment options and practical solutions. The revolutionary message is one of hope for millions of people--and a joyous opportunity for a better life.

Insightful, helpful, witty, and very practical. This book can change your life.
--Daniel G. Amen, M.D., author of Change Your Brain, Change Your Life

... contains information that is just not available anywhere else. This book is sure to become the authoritative guide for couples dealing with ADD.
--Patricia O. Quinn, M.D., Director, The National Center for Girls and Women with ADHD

...We expect this book will be the bible for all of us dealing with adult ADD.
-- Elizabeth Weathers and Diane Hartson, moderators, ADD Spouse support group

... I can safely predict it will become as much an 'industry standard' as Driven to Distraction.
--David Edelberg, M.D., Medical Director, WholeHealth Chicago

... The book is well researched, reader friendly, and includes insights and perspectives from a Who's Who of professionals. For couples struggling with ADHD, it's the season's new must-have book and bound to become a classic.
--Michele Novotni, Ph.D. Psychologist, Coach

Confirmatory brain neuroscience answers this speculation about Adult ADHD: It s a real problem with real and painful challenges, not a belief system.
-- Charles Parker, DO, Medical Director, CorePsych, author of Deep Recovery

... Gina Pera has combined a real feel for the disorder with sound reporting skills and the spice of those who tell the story best: the couples themselves.
-- Margaret D. Weiss, M.D., Ph.D., Head, Provincial ADHD Program, British Columbia, Canada

... Gina Pera has been there and has authored a guide that offers understanding for the confused, practical strategies for the frustrated, and hope for the despondent. This book will be a lifesaver for both partners.
-- Ari Tuckman, Psy.D., M.B.A., author of Integrative Treatment for Adult ADHD

Author: Gina Pera
Paperback: 369 pages
Company: 1201 Alarm Press (2008-08-31)
ISBN: 0981548709
List Price: $21.95
Amazon Price: $11.80
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"Huge changes"| "A different child"| "A miracle" | "Vast improvements"

This is what parents are saying about an amazing diet that is showing extraordinary results in helping children eliminate many traits and symptoms associated with autism spectrum disorders, ADHD, celiac disease, and other conditions. The Gluten-Free, Casein-Free (GFCF) Diet, as well as removing all artificial dyes and preservatives, is hugely effective for thousands of families.

The Autism & ADHD Diet is your complete guide to the GFCF Diet. Barrie Silberberg, a mother who honed her skills using the GFCF Diet with her son, who was diagnosed with ASD, gives you everything you need to know to put the diet into action with your child, including:

Packed with parent-proven tips and the best resources for the diet, The Autism & ADHD Diet will alleviate all of your questions and provide a variety of ways to make this diet work best for you and your family.

A companion video by Sandra Rief is also available for purchase. ADHD & LD: Powerful Teaching Strategies and Accommodations (ISBN: 0-7879-7472-2) provides a thorough, non-technical introduction to ADD and ADHD, with hundreds of practical instructional and behavioral strategies tested in diverse elementary and middle school classrooms. It is an excellent supplement to the ADHD Book of Lists.

Author: Sandra F. Rief M.A.
Paperback: 496 pages
Company: Jossey-Bass (2003-04-10)
ISBN: 078796591X
List Price: $32.95
Amazon Price: $18.81
Used Price: $9.78

TEENAGERS WITH ADD AND ADHD gives parents insight on everything from understanding the diagnosis to treatment options, and from behavioral and academic issues, to parent involvement and self-advocacy. The new edition includes additional or updated information in several areas. A separate chapter on medications provides details on specific drugs, including many new ones, and what research shows about their effectiveness in improving attention, impulse control, and distractibility. Dendy discusses new findings about the role of executive function problems and how they relate to teenagers difficulties with organizational skills, long-range planning, and staying on task. She advises parents on their role in working with schools to find strategies for academic success. Teenagers also speak out about their condition, and Dendy points to ways to involve them in their own treatment plan. In addition, the book covers coexisting disorders such as learning disabilities, depression, anxiety, Tourette syndrome, and Asperger syndrome.

Since 1995, this nuts and bolts guide has given parents hope and empowerment. It's chockfull of the latest data and proven strategies that can help manage the symptoms of ADD and ADHD at home and school.

Author: Chris A. Zeigler Dendy
Paperback: 424 pages
Company: Woodbine House (2006-09-30) (2006-09-30)
ISBN: 1890627313
List Price: $24.95
Amazon Price: $12.74
Used Price: $5.75

Every day, your school, your teachers, and even your peers draw lines to

measure and standardize intelligence. They decide what criteria make one person smart and another person stupid. They decide who will succeed and who will just get by. Perhaps you find yourself outside the norm, because you learn differently -- but, unlike your classmates, you have no system in place that consistently supports your ability and desire to learn. Simply put, you are considered lazy and stupid. You are expected to fail.

Learning Outside the Lines is written by two such "academic failures" -- that is, two academic failures who graduated from Brown University at the top of their class. Jonathan Mooney and David Cole teach you how to take control of your education and find true success -- and they offer all the reasons why you should persevere. Witty, bold, and disarmingly honest, Learning Outside the Lines takes you on a journey toward personal empowerment and profound educational change, proving once again that rules sometimes need to be broken.

Author: Jonathan Mooney, David Cole
Paperback: 288 pages
Company: Touchstone (2000-09-05) (2000-09-05)
ISBN: 068486598X
List Price: $15.99
Amazon Price: $4.97
Used Price: $0.29

Rev Neurol. 2012 Feb 16; 54(4): 241-8
Carrascosa-Romero MC, Suela J, Alfaro-Ponce B, Cepillo-Boluda AJ

X-chromosome-linked ichthyosis is caused by mutation or deletion of the STS gene associated with a deficiency of the enzyme steroid sulphatase, located in the distal part of the short arm of the X chromosome (Xp22.3-pter), close to the pseudo-autosomal region. Depending on its size, it can present as an isolated entity or combined with a syndrome caused by neighbouring genes, thus associating itself with other monogenic diseases as well as other mental disorders. The most relevant findings from the literature review are the importance of the Xp22.3-pter region and the higher incidence of neurological disorders among males (attention deficit hyperactivity disorder, autism and X-linked mental retardation). The role and implication of these genes in the disease are discussed and the authors suggest a possible contribution of the gene PNPLA4, which was originally described as GS2 and codes for calcium-independent phospholipase A2 beta, involved in lipoprotein metabolism, as one of the causes of autism. Improvements have been observed following treatment with citicoline, thanks to the role this nootropic plays in the biosynthesis of structural phospholipids involved in the formation and repair of the neuronal membrane.

J Clin Psychiatry. 2012 Jan 10;
Sutherland SM, Adler LA, Chen C, Smith MD, Feltner DE

OBJECTIVE: To examine the efficacy and safety of atomoxetine combined with buspirone versus atomoxetine monotherapy and placebo in adult attention-deficit/hyperactivity disorder (ADHD). METHOD: In this randomized, 8-week, 3-arm, double-blind, placebo-controlled trial conducted from November 2004 through December 2005, 241 adults with ADHD were randomly assigned in a 2:2:1 ratio to receive up to twice-daily atomoxetine and thrice-daily buspirone (n = 97), twice-daily atomoxetine (n = 97), or placebo (n = 47). Participants met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for ADHD. The primary efficacy measure was the adult ADHD Investigator Symptom Rating Scale (AISRS). RESULTS: Decrease in the AISRS total score was significantly greater for atomoxetine-buspirone than placebo at all time points from weeks 1 to 7, with an estimated mean difference of -4.80 (P = .001). Reduction in the mean AISRS total score was numerically greater for atomoxetine-buspirone than for atomoxetine at all time points, but statistically significant at week 4 only (estimated difference = -2.04, P < .10). The effect size for atomoxetine plus buspirone was 0.51, and for atomoxetine alone, it was 0.40. Insomnia, nausea, dry mouth, headache, and asthenia were frequently reported adverse events for both active treatment groups, and dizziness was also frequently reported for the atomoxetine-buspirone group. Discontinuations due to treatment-related adverse effects were 15.5% for atomoxetine-buspirone, 11.3% for atomoxetine, and 14.9% for placebo. CONCLUSIONS: There was little indication of improvement for atomoxetine plus buspirone versus atomoxetine monotherapy, as most efficacy measures showed only slightly greater quantitative improvement for the combination, generally without statistical significance. It is of note, however, that the quantitative differences between these 2 groups were virtually all in the direction of greater efficacy for the atomoxetine plus buspirone group. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00174226.

J Clin Psychiatry. 2012 Jan 10;
Turgay A, Goodman DW, Asherson P, Lasser RA, Babcock TF, Pucci ML, Barkley R,

BACKGROUND: The understanding that attention-deficit/hyperactivity disorder (ADHD) often persists throughout life has heightened interest of patients, families, advocates, and professionals in a longitudinal approach to management. Such an approach must recognize and address known patient- and systems-based challenges of long-term mental health treatment, shifting of clinical presentations of ADHD, and commonality of psychiatric comorbidity with ADHD. OBJECTIVE: The ADHD Life Transition Model is a step toward developing criteria to optimize recognition and clinical management of ADHD (eg, response, remission) across an individual's lifespan and across diverse medical subspecialties. To support therapeutic efficiency and adaptability, our proposed model highlights periods when external resources for managing ADHD are reduced, cognitive and behavioral stressors are increased, and individuals may be reevaluating how they perceive, accept, and adhere to ADHD treatment. Such a model aims to support the clinical community by placing in context new findings, which suggest that the prevention of adult psychopathology in individuals with pediatric ADHD may be possible. CONCLUSIONS: The ADHD Life Transition Model seeks to improve care for individuals with ADHD by (1) underscoring that ADHD persists beyond childhood in at least two-thirds of patients, (2) raising awareness of the need to approach ADHD from a chronic illness standpoint, and (3) increasing mental health professionals' diligence in symptom recognition and management of ADHD across developmental phases from childhood through adulthood.

Addiction. 2012 Mar; 107(3): 467-77
Kaye S, Darke S

Aims  To examine the literature pertaining to the diversion and misuse of pharmaceutical stimulants. Methods   Relevant literature was identified through comprehensive MEDLINE, EMBASE and PubMed searches. Results  The evidence to date suggests that the prevalence of diversion and misuse of pharmaceutical stimulants varies across adolescent and young adult student populations, but is higher than that among the general population, with the highest prevalence found among adults with attention deficit-hyperactive disorder (ADHD) and users of other illicit drugs. Concerns that these practices have become more prevalent as a result of increased prescribing are not supported by large-scale population surveys. Information on trends in misuse in countries where there have been recent increases in prescription and consumption rates, however, is limited. Little is known about the frequency and chronicity of misuse, or the extent of associated harms, particularly among those populations, i.e. adolescents, young adult student populations, those with ADHD and illicit drug users, where abuse may be more likely to occur. Conclusions  Continued monitoring of the diversion and misuse of pharmaceutical stimulants is of major clinical importance. Despite recognition of the abuse liability of these medications, there is a paucity of data on the prevalence, patterns and harms of diversion and misuse among populations where problematic use and abuse may be most likely to occur (e.g. adolescents, young adults, illicit drug users). Comprehensive investigations of diversion and misuse among these populations should be a major research priority, as should the assessment of abuse and dependence criteria among those identified as regular users.

Arch Pediatr Adolesc Med. 2012 Feb 6;
Nachman S, Chernoff M, Williams P, Hodge J, Heston J, Gadow KD

OBJECTIVE: To evaluate associations between human immunodeficiency virus (HIV) disease severity and psychiatric and functional outcomes in youth with perinatal HIV infection. DESIGN: Cross-sectional analysis of entry data from an observational, prospective 2-year study. Logistic and linear regression models adjusted for potential confounders were used. SETTING: Twenty-nine sites of the International Maternal Pediatrics Adolescent AIDS Clinical Trials Group study in the United States and Puerto Rico. PARTICIPANTS: Youth aged 6 to 17 years who had HIV infection (N = 319). Main Exposures  Antiretroviral treatment and perinatal HIV infection. MAIN OUTCOME MEASURES: Youth and primary caregivers were administered an extensive battery of measures that assessed psychiatric symptoms; cognitive, social, and academic functioning; and quality of life. RESULTS: Characteristics of HIV were a current CD4 percentage of 25% or greater (74% of participants), HIV RNA levels of less than 400 copies/mL (59%), and current highly active antiretroviral therapy (81%). Analyses indicated associations of past and current Centers for Disease Control and Prevention class C designation with less severe attention-deficit/hyperactivity disorder inattention symptoms, older age at nadir CD4 percentage and lower CD4 percentage at study entry with more severe conduct disorder symptoms, higher RNA viral load at study entry with more severe depression symptoms, and lower CD4 percentage at study entry with less severe symptoms of depression. There was little evidence of an association between specific antiretroviral therapy and severity of psychiatric symptoms. A lower nadir CD4 percentage was associated with lower quality of life, worse Wechsler Intelligence Scale for Children Coding Recall scores, and worse social functioning. CONCLUSION: Human immunodeficiency virus illness severity markers are associated with the severity of some psychiatric symptoms and, notably, with cognitive, academic, and social functioning, all of which warrant additional study. Trial Registration  clinicaltrials.gov Identifier: NCT00100542.

Atten Defic Hyperact Disord. 2012 Feb 5;
Lewis H, Lewis J

Stimulant medications used as first-line treatment in attention deficit hyperactivity disorder (ADHD) are contraindicated in patients with glaucoma. We present the first reported case of using methylphenidate therapy to safely and effectively treat ADHD in a pediatric patient with glaucoma.

Arq Neuropsiquiatr. 2012 Feb; 70(2): 91-6
Miranda MC, Barbosa T, Muszkat M, Rodrigues CC, Sinnes EG, Coelho LF, Rizzuti S, Palma SM, Bueno OF

This study investigated the performance of children with attention deficit hyperactivity disorder (ADHD) and dyslexia using Conners' Continuous Performance Test (CCPT). The clinical groups were composed of 52 children with ADHD and 32 children with dyslexia. Performance in the CCPT was evaluated using ANCOVA to compare the clinical groups with the normative Brazilian sample. The ADHD group performed worse than the normative sample in almost all of the measurements, except for reaction time and response style. The dyslexia group scored higher on commissions, variability, perseverations and inconsistency in the reaction time over the six time blocks (Hit SE Block Change) than the children in the normative Brazilian sample. The ADHD and dyslexia groups differed in omission measurements, Hit RT SE, variability, perseverations, Hit RT Interstimulus Intervals (ISI) Change and Hit SE ISI Change. We thus found that the dyslexia group had specific deficit patterns, with greater response to non-target stimuli, greater perseveration and response variability, and difficulties in hit reaction time as the test progressed.

Arq Neuropsiquiatr. 2012 Feb; 70(2): 83-4
Araujo AP

Eur Child Adolesc Psychiatry. 2012 Feb 5;
Myatchin I, Lemiere J, Danckaerts M, Lagae L

Working memory (WM) dysfunction and increased within-subject variability are known issues in attention deficit/hyperactivity disorder (ADHD) patients. Little is known about the electrophysiological characteristics of this variability. We evaluated behavioral and electrophysiological within-subject variability taking developmental aspects into account in a group of ADHD patients. Multichannel (n = 31) event-related potentials (ERP) were measured during a visuo-spatial backmatching task; 44 children (8-16 years old) were tested: 22 children with ADHD, combined (n = 17) and inattentive (n = 5) type, and 22 age- and intelligence-matched control children. One-backmatching (BM1) and two-backmatching (BM2) tasks were performed. Classical behavioral parameters and target and nontarget ERP were compared between groups. In addition, motor response variability and ERP amplitude variability were studied. Age-related changes in both motor response and ERP amplitude variability were analyzed in each group. Attention deficit/hyperactivity disorder children made more commission errors, which was more pronounced in the difficult (BM2) task. No difference between groups was found in ERP amplitude and in motor response variability. However, ADHD patients had higher ERP amplitude variability, which was again more pronounced in the difficult WM task. A delayed maturation of amplitude variability was seen in ADHD patients with a slower than in controls decrease in variability with age. This amplitude variability was correlated with the number of commissions, but in an opposite way for ADHD and control children. Our findings indicate an impaired visuo-spatial WM processing in ADHD children with greater ERP amplitude variability compared to controls. Our results also support the view of a delayed cortical development of visuo-spatial WM circuits in this disorder.

J Consult Clin Psychol. 2012 Feb 6;
Jarrett MA, Ollendick TH

Objective: The present study evaluated a 10-week psychosocial treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and a comorbid anxiety disorder. Method: Using a nonconcurrent multiple baseline design, the authors treated 8 children ages 8-12 with ADHD, combined type, and at least 1 of 3 major anxiety disorders (separation anxiety disorder, generalized anxiety disorder, social phobia). The integrated treatment protocol involved parent management training for ADHD and family-based cognitive-behavioral therapy for anxiety. Pretreatment assessments included semistructured diagnostic interviews and other standardized measures to determine study eligibility. Children were randomized to 1 of 3 baseline control conditions (i.e., 2, 3, or 4 weeks) and subsequently treated in a university-based psychosocial treatment clinic. Weekly assessments of ADHD and anxiety disorder symptoms occurred throughout treatment and comprehensive assessments were obtained at pretreatment, 1-week posttreatment, and 6-months posttreatment. Results: Single-case results supported greater success in the treatment phase relative to the baseline phase for both ADHD and anxiety symptoms, and ADHD and anxiety symptoms appeared to change concurrently. Pre-post group analyses revealed significant and clinically meaningful improvements in ADHD and anxiety symptoms at 1-week posttreatment, but only anxiety symptoms moved into the subclinical range. At 6-months follow-up, treatment effects were maintained with new movement into the subclinical range for ADHD. Conclusions: The present study provides initial data on an integrated treatment protocol for ADHD and anxiety. Further replication and evaluation are needed. Implications of the findings are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

J Atten Disord. 2012 Feb 3;
Young S, Hopkin G, Perkins D, Farr C, Doidge A, Gudjonsson G

Objective: There is a need to find effective treatments for individuals with antisocial and borderline personality disorder who are known to be difficult to engage and treat. Many of these individuals share considerable overlap with symptoms of ADHD, hence this study aimed to evaluate the Reasoning and Rehabilitation ADHD program (R&R2 ADHD) among patients with severe personality disorder. Method: A total of 31 males detained in a "dangerous and severe personality disorder" unit completed questionnaires at baseline and post treatment to assess social problem solving, violent attitudes, anger, ADHD symptoms, emotional control, and social functioning. A total of 16 patients participated in the group condition, and their scores were compared with 15 waiting-list controls who received treatment as usual. Results: In all, 76% of group participants completed the program. In contrast to controls, they showed significant improvements in scores with mainly medium effect sizes. Conclusion: R&R2 ADHD was effective in a small sample of severely personality-disordered offenders. (J. of Att. Dis. 2011; XX(X) 1-XX).

Brain Nerve. 2012 Feb; 64(2): 139-47
Kushima I, Okada T, Ozaki N

Abstract Developmental disorders, which are usually diagnosed in infancy, childhood, or adolescence, include mental retardation, learning disorders, motor skills disorder, communication disorders, pervasive developmental disorders (PDD), attention-deficit hyperactivity disorder (ADHD), and tic disorders. Epidemiological studies have indicated that these disorders are characterized not only by high heritability (e.g., 0.80 for PDD) but also by their shared genetic etiology. Furthermore, retrospective or prospective longitudinal studies have revealed that adult psychiatric disorders are often preceded either by their juvenile counterparts (homotypic continuity) or by different disorders (heterotypic continuity). Recent genetic studies have detected copy number variants (CNVs; e.g., deletions on 1q21.1, 3q29, and 22q.11.21 and duplications on 16p11.2) as shared genetic factors for PDD, mental retardation, and schizophrenia. While these CNVs are generally very rare (

Am J Med Genet A. 2012 Feb 3;
Silva G, Braga A, Leitão B, Mesquita A, Reis A, Duarte C, Barbot J, Silva ES

Adams-Oliver syndrome (AOS) is a rare condition defined by combination of cutis aplasia and transverse limb abnormalities. Some authors have described a possible association between this syndrome and portal hypertension (PH) due to hepatoportal sclerosis (HPS). We present a boy with AOS who developed a progressive splenomegaly and hypersplenism at the age of 2 months, and was admitted for acute gastrointestinal bleeding (GI) at the age of 9 months. Subsequently, we documented an extrahepatic portal vein obstruction and esophageal varices. After several episodes of cataclysmic upper GI bleeding a mesentero-portal shunt (MPS) was performed at 10 months. The shunt thrombosed, and after three failed attempts of thrombectomy, it was removed. One month later a splenorenal shunt was performed, and this closed spontaneously by 3 years. The patient suffered from ischemic stroke after placing the first shunt, and has spastic diplegia, left frontal lobe epilepsy, hyperactivity and attention deficit disorder, and severe psychomotor delay. At 11 years and he presented with chronic liver failure and hyperammonemia and coagulopathy. We hypothesize that there may be an early embryonic vascular abnormality (vascular disruption) that may explain these vascular phenomena. © 2012 Wiley Periodicals, Inc.

Arch Clin Neuropsychol. 2012 Feb 3;
Chang YK, Liu S, Yu HH, Lee YH

This study was conducted to determine the effect of acute aerobic exercise on executive function in children with attention deficit hyperactivity disorder (ADHD). Forty children with ADHD were randomly assigned into exercise or control groups. Participants in the exercise group performed a moderate intensity aerobic exercise for 30 min, whereas the control group watched a running/exercise-related video. Neuropsychological tasks, the Stroop Test and the Wisconsin Card Sorting Test (WCST), were assessed before and after each treatment. The results indicated that acute exercise facilitated performance in the Stroop Test, particularly in the Stroop Color-Word condition. Additionally, children in the exercise group demonstrated improvement in specific WCST performances in Non-perseverative Errors and Categories Completed, whereas no influences were found in those performances in the control group. Tentative explanations for the exercise effect postulate that exercise allocates attention resources, influences the dorsolateral prefrontal cortex, and is implicated in exercise-induced dopamine release. These findings are promising and additional investigations to explore the efficacy of exercise on executive function in children with ADHD are encouraged.

Eur J Paediatr Neurol. 2012 Feb 1;
Cortese S

This review, addressed mainly to clinicians, considers commonly asked questions related to the neuroimaging, neurophysiology, neurochemistry and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD). It provides answers based on the most recent meta-analyses and systematic reviews, as well as additional relevant original studies. Empirical findings from neurobiological research into ADHD reflect a shift in the conceptualisation of this disorder from simple theoretical views of a few isolated dysfunctions to more complex models integrating the heterogeneity of the clinical manifestations of ADHD. Thus, findings from structural and functional neuroimaging suggest the involvement of developmentally abnormal brain networks related to cognition, attention, emotion and sensorimotor functions. Brain functioning alterations are confirmed by neurophysiological findings, showing that individuals with ADHD have elevated theta/beta power ratios, and less pronounced responses and longer latencies of event-related potentials, compared with controls. At a molecular level, alterations in any single neurotransmitter system are unlikely to explain the complexity of ADHD; rather, the disorder has been linked to dysfunctions in several systems, including the dopaminergic, adrenergic, serotoninergic and cholinergic pathways. Genetic studies showing a heritability of ∼60-75% suggest that a plethora of genes, each one with a small but significant effect, interact with environmental factors to increase the susceptibility to ADHD. Currently, findings from neurobiological research do not have a direct application in daily clinical practice, but it is hoped that in the near future they will complement the diagnostic process and contribute to the long-term effective treatment of this impairing condition.

Neurosci Biobehav Rev. 2012 Jan 24;
van Ewijk H, Heslenfeld DJ, Zwiers MP, Buitelaar JK, Oosterlaan J

Diffusion tensor imaging (DTI) allows in vivo examination of the microstructural integrity of white matter brain tissue. A systematic review and quantitative meta-analysis using GingerALE were undertaken to compare current DTI findings in patients with ADHD and healthy controls to further unravel the neurobiological underpinnings of the disorder. Online databases were searched for DTI studies comparing white matter integrity between ADHD patients and healthy controls. Fifteen studies met inclusion criteria. Alterations in white matter integrity were found in widespread areas, most consistently so in the right anterior corona radiata, right forceps minor, bilateral internal capsule, and left cerebellum, areas previously implicated in the pathophysiology of the disorder. Current literature is critically discussed in terms of its important methodological limitations and challenges, and guidelines or future DTI research are provided. While more research is needed, DTI proves to be a promising technique, providing new prospects and challenges for future research into the pathophysiology of ADHD.

Compr Psychiatry. 2012 Feb 1;
Harrington KM, Miller MW, Wolf EJ, Reardon AF, Ryabchenko KA, Ofrat S

This study examined attention-deficit/hyperactivity disorder (ADHD) comorbidity in military veterans with a high prevalence of posttraumatic stress disorder (PTSD) and evaluated the relationships between the 2 disorders and exposure to traumatic events. The sample included 222 male and female military veterans who were administered structured clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Results show that 54.5% met the criteria for current PTSD, 11.5% of whom also met the criteria for current adult ADHD. Level of trauma exposure and ADHD severity were significant predictors of current PTSD severity. Evaluation of the underlying structure of symptoms of PTSD and ADHD using confirmatory factor analysis yielded a best-fitting measurement model that comprised 4 PTSD factors and 3 ADHD factors. Standardized estimates of the correlations among PTSD and ADHD factors suggested that the largest proportion of shared variance underlying PTSD-ADHD comorbidity is related to problems with modulating arousal levels that are common to both disorders (ie, hyperarousal and hypoarousal).

J Psychiatr Res. 2012 Feb 1;
Duarte NA, Woods SP, Rooney A, Atkinson JH, Grant I,

Methamphetamine (MA) use and Attention-Deficit/Hyperactivity Disorder (ADHD) commonly co-occur and are independently associated with dysregulation of frontostriatal loops and risky decision-making; however, whether their comorbidity exacerbates risky decision-making is not known. This study evaluated 23 participants with histories of MA dependence and ADHD (MA+ADHD+), 25 subjects with MA dependence alone (MA+ADHD-), and 22 healthy adults (MA-ADHD-), who completed the Iowa Gambling Task (IGT) as part of a larger neuropsychiatric research evaluation. Results showed a significant interaction between ADHD, MA, and working memory, such that individuals with working memory deficits in the MA+ADHD+ cohort demonstrated the strongest propensity to select cards from "disadvantageous" versus "advantageous" decks on the IGT. This effect was not better explained by other psychiatric, substance use, neuromedical, or cognitive factors. Findings suggest that working memory deficits may moderate the expression of risky decision-making in MA users with ADHD.

Mayo Clin Proc. 2012 Feb; 87(2): 120-9
Sprung J, Flick RP, Katusic SK, Colligan RC, Barbaresi WJ, Bojanić K, Welch TL, Olson MD, Hanson AC, Schroeder DR, Wilder RT, Warner DO

To study the association between exposure to procedures performed under general anesthesia before age 2 years and development of attention-deficit/hyperactivity disorder (ADHD).Study patients included all children born between January 1, 1976, and December 31, 1982, in Rochester, MN, who remained in Rochester after age 5. Cases of ADHD diagnosed before age 19 years were identified by applying stringent research criteria. Cox proportional hazards regression assessed exposure to procedures requiring general anesthesia (none, 1, 2 or more) as a predictor of ADHD using a stratified analysis with strata based on a propensity score including comorbid health conditions.Among the 5357 children analyzed, 341 ADHD cases were identified (estimated cumulative incidence, 7.6%; 95% confidence interval [CI], 6.8%-8.4%). For children with no postnatal exposure to procedures requiring anesthesia before the age of 2 years, the cumulative incidence of ADHD at age 19 years was 7.3% (95% CI, 6.5%-8.1%). For single and 2 or more exposures, the estimates were 10.7% ( 95% CI, 6.8%-14.4%) and 17.9% ( 95% CI, 7.2%-27.4%), respectively. After adjusting for gestational age, sex, birth weight, and comorbid health conditions, exposure to multiple (hazard ratio, 1.95; 95% CI, 1.03-3.71), but not single (hazard ratio,1.18; 95% CI, 0.79-1.77), procedures requiring general anesthesia was associated with an increased risk for ADHD.Children repeatedly exposed to procedures requiring general anesthesia before age 2 years are at increased risk for the later development of ADHD even after adjusting for comorbidities.

J Womens Health (Larchmt). 2012 Feb 3;
Hosain GM, Berenson AB, Tennen H, Bauer LO, Wu ZH

Abstract Background: This study was undertaken to assess the association between adult attention deficit/hyperactivity disorder (ADHD) symptoms and high-risk sexual behavior. Methods: This cross-sectional study interviewed 462 low-income women aged 18-30 years. We used the 18-item Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist to assess ADHD symptoms. Risky sexual behaviors included sex before 15 years of age, risky sex partners in lifetime, number of sex partners in the last 12 months, condom use in the last 12 months, alcohol use before sex in the last 12 months, traded sex in lifetime, and diagnosed with sexually transmitted infection (STI) in lifetime. Results: Mean ADHD symptom score was 19.8 (SD±12.9), and summary index of all risky sexual behavior was 1.77 (SD±1.37). Using unadjusted odds ratios (OR), women who endorsed more ADHD symptoms reported engaging in more risky sexual behaviors of all types. However, when multivariable logistic regression was applied adjusting for various sociodemographic covariates, the adjusted ORs remained significant for having risky sex partners and having ≥3 sex partners in the prior 12 months. We observed some differences in risky sexual behavior between two domains of ADHD. Conclusions: The ADHD symptom score appears to be associated with some risky sexual behaviors and deserves further attention. A brief ADHD screening can identify this high-risk group for timely evaluation and safe sex counseling.