Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA.
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.
Res Child Adolesc Psychopathol. 2021 Jul;49(7):835-848. doi: 10.1007/s10802-021-00792-2. Epub 2021 Mar 1.
This study examined whether girls and boys with ADHD show similar impairments in cognitive control from childhood into adolescence and the developmental relationship between cognitive control and ADHD symptoms. Participants include 8-17-year-old children with ADHD (n = 353, 104 girls) and typically developing (TD) controls (n = 241, 86 girls) with longitudinal data obtained from n = 137. Participants completed two go/no-go (GNG) tasks that varied in working memory demand. Linear mixed-effects models were applied to compare age-related changes in cognitive control for each GNG task among girls and boys with ADHD and TD controls and in relation to ADHD symptoms. Boys with ADHD showed impaired response inhibition and increased response variability across tasks. In contrast, girls with ADHD showed impaired response inhibition only with greater working memory demands whereas they displayed increased response variability regardless of working memory demands. Analysis of age-related change revealed that deficits in cognitive control under minimal working memory demands increase with age among girls with ADHD and decrease with age among boys with ADHD. In contrast, deficits in cognitive control with greater working memory demands decrease with age among both boys and girls with ADHD compared to TD peers. Among children with ADHD poor response inhibition during childhood predicted inattentive symptoms in adolescence and was associated with less age-related improvement in inattentive symptoms. These findings suggest that girls and boys with ADHD show differential impairment in cognitive control across development and response inhibition in childhood may be an important predictor of ADHD symptoms in adolescence.
本研究考察了 ADHD 儿童在从儿童期到青春期期间的认知控制是否存在相似的缺陷，以及认知控制与 ADHD 症状之间的发展关系。参与者包括患有 ADHD（n=353，104 名女孩）和具有纵向数据的正常发育（TD）对照组（n=241，86 名女孩）的 8-17 岁儿童，共 n=137。参与者完成了两项 Go/No-Go（GNG）任务，这些任务在工作记忆需求方面有所不同。线性混合效应模型用于比较 ADHD 和 TD 对照组中男孩和女孩在每个 GNG 任务中的认知控制随年龄的变化，以及与 ADHD 症状的关系。患有 ADHD 的男孩在所有任务中均表现出抑制反应的缺陷和反应变异性的增加。相比之下，患有 ADHD 的女孩仅在工作记忆需求较高时表现出抑制反应的缺陷，而在工作记忆需求无论高低时，她们都表现出反应变异性的增加。分析年龄相关的变化表明，在最小工作记忆需求下认知控制的缺陷在患有 ADHD 的女孩中随年龄的增长而增加，在患有 ADHD 的男孩中随年龄的增长而减少。相比之下，患有 ADHD 的男孩和女孩在具有较大工作记忆需求的情况下，认知控制的缺陷随年龄的增长而减少，而与 TD 同龄人相比，认知控制的缺陷随年龄的增长而减少。在患有 ADHD 的儿童中，童年时期较差的反应抑制预示着青春期的注意力不集中症状，并且与注意力不集中症状的年龄相关改善程度降低有关。这些发现表明，患有 ADHD 的男孩和女孩在整个发展过程中表现出不同的认知控制缺陷，而童年时期的反应抑制可能是青春期 ADHD 症状的一个重要预测因素。
