Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 430, 40530, Göteborg, Sweden.
Psychiatry Department, Clinic for Neurology and Psychiatry for Children and Youth, Dr Subotic 6a, 11000, Belgrade, Serbia.
BMC Psychiatry. 2022 Apr 20;22(1):282. doi: 10.1186/s12888-022-03878-3.
The continuous performance task (CPT) may help identify coexistent attention deficit hyperactivity disorder (ADHD) in autism spectrum disorder (ASD). The Quantified behavior Test (QbTest) combines a CPT and motion-tracking data to assess ADHD symptoms. This study aimed to evaluate the QbTest performance of children and adolescents with ASD plus ADHD, including estimating the effects of single-dose methylphenidate (MPH). To achieve these aims, (1) the QbTest performances were evaluated in ASD alone, ASD plus ADHD, and ADHD alone, and (2) the effects on the QbTest performance of single-dose MPH before and after intake were estimated across the groups. It was assumed that the ASD plus ADHD performance, including the MPH response, would preferably resemble the performance in ADHD alone, rather than ASD alone.
Retrospective data were analyzed for 482 children and adolescents: 69 with ASD alone, 142 with ASD plus ADHD (ASD/ADHD), and 271 with ADHD alone. For 343 subjects, the QbTest was performed before and up to four hours after a single-dose MPH intake. A summary index of the CPT and motion-capture data was provided for QbTest cardinal parameters.
Of 12 QbTest parameters assessed before given MPH, the ASD/ADHD group had scores in line with the ASD group regarding four parameters and the ADHD group regarding nine parameters. Significant differences between groups were seen with respect to QbInattention (p > 0.05); the lowest scores in ASD and the highest in ADHD. Those with ASD/ADHD and ADHD had similar QbActivity and QbImpulsivity scores, but significantly higher than those with ASD. After MPH intake, scores for QbActivity decreased similarly in ASD/ADHD and ADHD, as well as scores for QbImpulsivity. QbImpulsivity increased in ASD. QbInattention scores decreased similarly in all groups after MPH intake.
Children and adolescents with ASD plus ADHD exhibited more atypical QbTest performances than those with ASD alone, while most of their performances were similar to those observed in ADHD alone. In addition, a single dose of MPH mitigated attention deficits and decreased hyperactivity while improved impulsivity in these children. Prospective studies should further clarify the role of the QbTest in the diagnostic and therapeutic interventions in ASD with ADHD.
连续表现任务（CPT）可能有助于识别自闭症谱系障碍（ASD）中并存的注意力缺陷多动障碍（ADHD）。量化行为测试（QbTest）将 CPT 和运动跟踪数据相结合，以评估 ADHD 症状。本研究旨在评估 ASD 合并 ADHD 儿童和青少年的 QbTest 表现，包括估计单剂量哌醋甲酯（MPH）的影响。为了实现这些目标，（1）评估 ASD 单一、ASD 合并 ADHD 和 ADHD 单一组的 QbTest 表现，（2）估计各组单剂量 MPH 摄入前后对 QbTest 表现的影响。假设 ASD 合并 ADHD 的表现，包括 MPH 的反应，最好类似于 ADHD 单一组的表现，而不是 ASD 单一组的表现。
对 482 名儿童和青少年进行了回顾性数据分析：69 名患有 ASD 单一组，142 名患有 ASD 合并 ADHD（ASD/ADHD），271 名患有 ADHD 单一组。对于 343 名受试者，在单剂量 MPH 摄入前和摄入后四小时内进行了 QbTest。CPT 和运动捕捉数据的摘要指数为 QbTest 主要参数提供了信息。
在给予 MPH 之前评估的 12 个 QbTest 参数中，ASD/ADHD 组在四个参数方面与 ASD 组相似，在九个参数方面与 ADHD 组相似。组间差异具有统计学意义，表现在 Qb 注意力不集中（p > 0.05）方面；ASD 组得分最低，ADHD 组得分最高。ASD/ADHD 和 ADHD 组的 Qb 活动和 Qb 冲动性评分相似，但明显高于 ASD 组。MPH 摄入后，ASD/ADHD 和 ADHD 组的 Qb 活动评分相似下降，Qb 冲动性评分也相似下降。ASD 组的 Qb 冲动性评分增加。MPH 摄入后，所有组的 Qb 注意力不集中评分相似下降。
与 ASD 单一组相比，ASD 合并 ADHD 的儿童和青少年表现出更典型的 QbTest 表现，而他们的大多数表现与 ADHD 单一组相似。此外，单剂量 MPH 可减轻这些儿童的注意力缺陷，并降低多动性，同时改善冲动性。前瞻性研究应进一步阐明 QbTest 在 ASD 合并 ADHD 的诊断和治疗干预中的作用。
