A Study Of Executive Function In Male Children With Functional Abnomality In Cortico-Striatal-Thalamo-Cortical Circuit

Background : With the same pathological neuroimaging basis in Cortico-striato-thalamic-Cortical( CSTC) circuit,there are abnormal functional connectivities in attention deficit hyperactivity disorder(ADHD), obsessive-compulsive disorder(OCD) and Tourette’s syndrome(TS). The abnormal functional connectivities in CSTC circuit may impair children’s executive function.Objective:To measure the executive function in male children with ADHD,OCD and Tourette’s syndrome(TS) selected as subjects for definite abnormal CSTC circuit function.Methods: The study used common neuropsychological test including Stroop Color-Word Interference Test(Stroop) and Choice Delay Task(CPT) to respectively assess response inhibition in “cool” executive function and delay aversion in “hot” executive function. Test one: Thirty-six boys with ADHD,36 with ADHD+TS,30 with TS,and 50 typically developing boys(healthy control,HC) recruited from out-patient department and local community mathched with age,gender, and IQ were as subjects.Patients’ diagnoses were made according to the International Classification of Diseases Tenth Revision(ICD-10).Subjects were assessed with Stroop to evaluate response inhibition. Test two: Forty boys with ADHD,40 with OCD,and 40 with HC recruited from out-patient department and local community mathched with age,gender, and IQ.Patients’ diagnoses were made according to ICD-10.Subjects were assessed with choice delay task(CDT1/CDT2) to evaluate delay aversion under the condition of normal ecological validity or high ecological validity respectively.Results:The obtained data sets were then analysed with One-Way ANOVA and Post-hoc test.The Stroop scores were higher in Boys with ADHD than others, there were no difference among boys with TS-only,TS-plus-ADHD and HC(F=3.49,P=0.017) in test one. The CPT1/CPT2 scores were both lower in boys with ADHD than HC,the CPT1/CDT2 scores were both higher in boys with OCD than HC(F=24.66/12.30,Ps<0.001) in test two.There were no difference on reaction time among the boys with ADHD,OCD and HC(F=0.92/1.53,P=0.403/0.222).Conclusions:Test one indicated that ADHD may be provided with response inhibition deficit,but no evidence showed ADHD +TS was found the phenomenon above. The comorbidity of ADHD and TS might be responsible for the lack of neuropsychological deficit,or at least those assessed in the present diagnostic system. Test two indicated that ADHD may be provided with delay aversion, delayed gratification deficit was regarded as a presentation skill deficit in progress of inhibited behavior,that was on the opposite of OCD.The nosogenesis of hyperactivity or impulsivity may be different between OCD and ADHD in delay aversion.