Cross-Disorder Cognitive Impairments in Youth Referred for Neuropsychiatric Evaluation.
Cross-Disorder Cognitive Impairments in Youth Referred for Neuropsychiatric Evaluation.
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DOI：
10.1017/s1355617717000601
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发表时间：
2018-01
期刊：
影响因子：
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通讯作者：
Braaten EB
中科院分区：
文献类型：
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作者：
Doyle AE;Vuijk PJ;Doty ND;McGrath LM;Willoughby BL;O'Donnell EH;Wilson HK;Colvin MK;Toner DC;Hudson KE;Blais JE;Ditmars HL;Faraone SV;Seidman LJ;Braaten EB
研究表明，某些相同认知领域的损伤发生在不同的神经精神疾病中，包括那些已知具有遗传倾向的疾病。然而，直接的，多功能认知障碍的比较是有限的，目前还不清楚是否重叠的缺陷是由于合并症。我们的目的是通过检查不同神经精神疾病的认知和解决合并症来扩展文献。受试者为486名连续接受神经精神评估的青少年，并参加了遗传对认知影响的纵向研究。首先，我们评估了一般能力，反应时间变异性（RTV）和执行功能（EF）方面的青年与非共病形式的注意力缺陷/多动障碍（ADHD），情绪障碍和自闭症谱系障碍（ASD）以及青年精神病。其次，我们确定了共病ADHD对ASD和情绪障碍青年认知的影响。对于EF（工作记忆，抑制和转移/灵活性），当参与者自己的能力是指涉时，我们观察到所有诊断组的弱点。与已发表的规范性数据相比，下降幅度很小。对于RTV，在患有ADHD和情绪障碍的青少年中出现了弱点，但趋势水平的结果不能排除其他条件的减少。ADHD的合并症并没有影响ASD或情绪障碍青少年的弱点模式，但增加了情绪障碍青少年的减少幅度。患有ADHD、情绪障碍、ASD和精神病的青少年表现出EF弱点，而不是由于合并症。这种认知困难是否反映了这些疾病之间的遗传责任，需要进一步研究。
Studies suggest that impairments in some of the same domains of cognition occur in different neuropsychiatric conditions, including those known to share genetic liability. Yet, direct, multi-disorder cognitive comparisons are limited, and it remains unclear whether overlapping deficits are due to comorbidity. We aimed to extend the literature by examining cognition across different neuropsychiatric conditions and addressing comorbidity. Subjects were 486 youth consecutively referred for neuropsychiatric evaluation and enrolled in the Longitudinal Study of Genetic Influences on Cognition. First, we assessed general ability, reaction time variability (RTV) and aspects of executive functions (EFs) in youth with non-comorbid forms of attention-deficit/hyperactivity disorder (ADHD), mood disorders and autism spectrum disorder (ASD) as well as in youth with psychosis. Second, we determined the impact of comorbid ADHD on cognition in youth with ASD and mood disorders. For EFs (working memory, inhibition and shifting/ flexibility), we observed weaknesses in all diagnostic groups when participants’ own ability was the referent. Decrements were subtle in relation to published normative data. For RTV, weaknesses emerged in youth with ADHD and mood disorders, but trend-level results could not rule out decrements in other conditions. Comorbidity with ADHD did not impact the pattern of weaknesses for youth with ASD or mood disorders but increased the magnitude of the decrement in those with mood disorders. Youth with ADHD, mood disorders, ASD, and psychosis show EF weaknesses that are not due to comorbidity. Whether such cognitive difficulties reflect genetic liability shared among these conditions requires further study.