Neuropsychological subgroups in ADHD

[P.Stibbons]

Distinct neuropsychological subgroups in typically developing youth inform heterogeneity in children with ADHD

   Damien A. Faira,b,c,1,
   Deepti Bathulaa,d,
   Molly A. Nikolase, and
   Joel T. Nigga,b

+ Author Affiliations

   Departments of aBehavioral Neuroscience and
   bPsychiatry and
   cAdvanced Imaging Research Center, Oregon Health and Science University, Portland, OR 97239;
   dDepartment of Computer Science and Engineering, Indian Institute of Technology Ropar, Rupagnar, India 140001; and
   eDepartment of Psychology, University of Iowa, Iowa City, IA 52242

   Edited by James Swanson, University of California, Irvine, CA, and accepted by the Editorial Board February 24, 2012 (received for review September 23, 2011)

Abstract

Research and clinical investigations in psychiatry largely rely on the de facto assumption that the diagnostic categories identified in the Diagnostic and Statistical Manual (DSM) represent homogeneous syndromes. However, the mechanistic heterogeneity that potentially underlies the existing classification scheme might limit discovery of etiology for most developmental psychiatric disorders. Another, perhaps less palpable, reality may also be interfering with progress—heterogeneity in typically developing populations.

In this report we attempt to clarify neuropsychological heterogeneity in a large dataset of typically developing youth and youth with attention deficit/hyperactivity disorder (ADHD), using graph theory and community detection. We sought to determine whether data-driven neuropsychological subtypes could be discerned in children with and without the disorder. Because individual classification is the sine qua non for eventual clinical translation, we also apply support vector machine-based multivariate pattern analysis to identify how well ADHD status in individual children can be identified as defined by the community detection delineated subtypes. The analysis yielded several unique, but similar subtypes across both populations.

Just as importantly, comparing typically developing children with ADHD children within each of these distinct subgroups increased diagnostic accuracy. Two important principles were identified that have the potential to advance our understanding of typical development and developmental neuropsychiatric disorders. The first tenet suggests that typically developing children can be classified into distinct neuropsychological subgroups with high precision. The second tenet proposes that some of the heterogeneity in individuals with ADHD might be "nested" in this normal variation.

http://www.pnas.org/content/early/2012/03/30/1115365109.abstract

http://www.aerztezeitung.de/medizin/krankheiten/neuro-psychiatrische_krankheiten/adhs/article/809806/adhs-familie-multipler-krankheiten.html