Still little is known about neuropsychological differences between boys and girls with attention-deficit/hyperactivity disorder (ADHD) and whether there are sex-specific differences in the modulation of attentional performance by methylphenidate (MPH).
Method:
In this study, 27 males and 27 females between 8–12 years old and with ADHD were investigated in a double-blind, placebo-controlled trial on five computerized attention tests (0.25 vs. 0.5 mg/kg MPH as a single dose, versus placebo).
Results:
Boys and girls with ADHD did not differ with respect to age, intelligence quotient (IQ), symptom severity, co-morbidity patterns, and ADHD subtype. However, ADHD boys were more impulsive on a sustained attention task, whereas girls with ADHD had more deficits on tasks measuring selective attention. Attentional performance increased differentially as a function of MPH dose, with some tasks showing linear improvement with higher dosage whereas more complex tasks in particular showed inverse U-shaped patterns of MPH effects. However, these effects were comparable between girls and boys.
Conclusions:
Our data suggest that there are some gender differences in attentional performance in subjects with ADHD in a clinical sample, even if symptom severity and co-morbidity are controlled; however, modulation of attention by MPH does not seem to differ between sexes.
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References
1.
AbikoffHB, JensenPS, ArnoldLL, HozaB, HechtmanL, PollackS, MartinD, AlvirJ, MarchJS, HinshawS, VitelloB, NewcornJ, GreinerA, CantwellDP, ConnersCK, ElliottG, GreenhillLL, KraemerH, PelhamWEJ, SevereJB, SwansonJM, WellsK, WigalT. Observed classroom behavior of children with ADHD: Relationship to gender and comorbidity. J Abnorm Child Psychol, 4:349–359. 2002.
2.
American Academy of Child and Adolescent Psychiatry. A practice parameter for the use of stimulant medications. J Am Acad Child Adolesc Psychiatry, 10:26S–49S. 2002.
3.
American Psychiatric Association. Diagnostic, and Statistical Manual of Mental Disorders. 4th(DSM-IV)Washington (DC): American Psychiatric Association, 1994.
BarbaresiWJ, KatusicSK, ColliganRC, WeaverAL, LeibsonCL, JacobsenSJ. Long-term stimulant medication treatment of attention-deficit/hyperactivity disorder: Results from a population-based study. J Devel Behav Pediatrics, 1:1–10. 2006.
6.
BedardAC, JainU, JohnsonSH, TannockR. Effects of methylphenidate on working memory components: Influence of measurement. J Child Psychol Psychiatry, 9:872–880. 2007.
7.
BiedermanJ, KwonA, AleardiM, ChouinardVA, MarinoT, ColeH, MickE, FaraoneSV. Absence of gender effects on attention deficit hyperactivity disorder: Findings in nonreferred subjects. Am J Psychiatry, 6:1083–1089. 2005.
8.
CabezaR, NybergL. Imaging Cognition II: An Empirical Review of 275 PET and fMRI Studies. J Cogn Neurosci, 1:1–47. 2000.
9.
CahillL. Why sex matters for neuroscience. Nat Rev Neurosci, 6:477–484. 2006.
10.
CarlsonCL, TammL, GaubM. Gender differences in children with ADHD, ODD, and co-occurring ADHD/ODD identified in a school population. J Am Acad Child Adolesc Psychiatry, 12:1706–1714. 1997.
11.
CharachA, CaoH, SchacharR, ToT. Correlates of methylphenidate use in Canadian children: A cross-sectional study. Canad J Psychiatry, 1:17–26. 2006.
12.
CuffeSP, MooreCG, McKeownRE. Prevalence and correlates of ADHD symptoms in the national health interview survey. J Atten Disord, 2:392–401. 2005.
13.
de SonnevilleLMJ. ANT 2.1—Amsterdam Neuropsychological Tasks. Amstelveen: Sonar, 2000.
14.
DöpfnerM, PlückJ, BölteS, LenzK, MelchersP, HeimK. Elternfragebogen über das Verhalten von Kindern und Jugendlichen. (CBCL 4-18)Göttingen: Hogrefe Testzentrale, 1998.
15.
EpsteinJN, GoldbergN, ConnersCK, MarchJS. The effects of anxiety on CPT performance in an ADHD clinic sample. J Attention Disord, 2:45–52. 1997.
16.
EpsteinJN, ConnersCK, HerveyAS, TonevST, ArnoldLE, AbikoffHB, ElliottG, GreenhillLL, HechtmanL, HoagwoodK, HinshawSP, HozaB, JensenPS, MarchJS, NewcornJH, PelhamWE, SevereJB, SwansonJM, WellsK, VitielloB, WigalT. Assessing medication effects in the MTA study using neuropsychological outcomes. J Child Psychol Psychiatry, 5:446–456. 2006.
17.
FimmB, ZimmermannP. Testbatterie zur Aufmerksamkeitsüberprüfung (TAP)—Version 1.6. Herzogenrath: Psytest, 2001.
18.
GaubM, CarlsonCL. Gender differences in ADHD: A meta-analysis and critical review. J Am Acad Child Adolesc Psychiatry, 8:1036–1045. 1997.
19.
GershonJ. A meta-analytic review of gender differences in ADHD. J Atten Disord, 3:143–154. 2002.
20.
GuevaraJ, LozanoP, WickizerT, MellL, GephartH. Psychotropic medication use in a population of children who have attention-deficit/hyperactivity disorder. Pediatrics, 5:733–739. 2002.
21.
GüntherT, JollesJ, Herpertz-DahlmannB, KonradK. Age-dependent differences in attentional processes in ADHD and disruptive behavior disorder. Develop Neuropsychol, 34:422–434. 2009.
22.
HalperinJM, O'BrienJD, Newcorn JH., HealeyJM, Pascualvaca DM., WolfLE, YoungJG. Validation of hyperactive, aggressive, and mixed hyperactive/aggressive childhood disorders: A research note. J Child Psychol Psychiatry, 3:455–459. 1990.
23.
HoagwoodK, KelleherKJ, FeilM, ComerDM. Treatment services for children with ADHD: A national perspective. J Am Acad Child Adolesc Psychiatry, 2:198–206. 2000.
24.
JacobsenLK, SlotkinTA, MenclWE, FrostSJ, PughKR. Gender-specific effects of prenatal and adolescent exposure to tobacco smoke on auditory and visual attention. Neuropsychopharmacology, 12:2453–2464. 2007.
25.
JusticeAJ, de WitH. Acute effects of d-amphetamine during the follicular and luteal phases of the menstrual cycle in women. Psychopharmacology, 1:67–75. 1999.
26.
JusticeAJ, de WitH. Acute effects of d-amphetamine during the early and late follicular phases of the menstrual cycle in women. Pharmacol Biochem Behav, 3:509–515. 2000.
27.
KemptonS, VanceA, MaruffP, LukE, CostinJ, PantelisC. Executive function and attention deficit hyperactivity disorder: Stimulant medication and better executive function performance in children. Psychol Med, 29:527–538. 1999.
28.
KochK, PaulyK, KellermannT, SeiferthNY, ReskeM, BackesV, StockerT, ShahNJ, AmuntsK, KircherT, SchneiderF, HabelU. Gender differences in the cognitive control of emotion: An fMRI study. Neuropsychologia, 12:2744–2754. 2007.
29.
KonradK, GüntherT, HanischC, Herpertz-DahlmannB. Differential effects of methylphenidate on attentional functions in children with attention deficit/ hyperactivity disorder. J Am Acad Child Adolesc Psychiatry, 2:191–198. 2004.
30.
LevyF, HayDA, BennettKS, McStephenM. Gender differences in ADHD subtype comorbidity. J Am Acad Child Adolesc Psychiatry, 4:368–376. 2005.
31.
MillerAR, KohenD, JohnstonC. Child characteristics and receipt of stimulant medications: A population-based study. Ambul Pediatrics, 3:175–181. 2008.
32.
NewcornJH, HalperinJM, JensenPS, AbikoffHB, ArnoldLE, CantwellDP, ConnersCK, ElliottGR, EpsteinJN, GreenhillLL, HechtmanL, HinshawSP, HozaB, KraemerHC, PelhamWE, SevereJB, SwansonJM, WellsKC, WigalT, VitielloB. Symptom profiles in children with ADHD: effects of comorbidity and gender. J Am Acad Child Adolesc Psychiatry, 2:137–146. 2001.
33.
PiefkeM, WeissPH, MarkowitschHJ, FinkGR. Gender differences in the functional neuroanatomy of emotional episodic autobiographical memory. Hum Brain Mapping, 4:313–324. 2005.
34.
PolanczykG., FaraoneS. V., BauC. H., VictorM. M., BeckerK., PelzR, PelzR, BuitelaarJK, FrankeB, KooijS, van der MeulenE, CheonKA, MickE, Purper-OuakilD, GorwoodP, SteinMA, CookEH, RohdeLA. The impact of individual and methodological factors in the variability of response to methylphenidate in ADHD pharmacogenetic studies from four different continents. Am J Med Genet B Neuropsychiatr Genet, 147B:1419–1424. 2008.
35.
RapportMD, DenneyC. Titrating methylphenidate in children with attention deficit/hyperactivity disorder: Is body mass predictive of clinical response. J Am Acad Child Adolesc Psychiatry, 4:523–530. 1997.
36.
RucklidgeJJ. Gender differences in ADHD: Implications for psychosocial treatments. Exp Rev Neurotherapeut, 4:643–655. 2008.
37.
RucklidgeJJ, TannockR. Psychiatric, psychosocial, and cognitive functioning of female adolescents with ADHD. J Am Acad Child Adolesc Psychiatry, 5:530–540. 2001.
38.
RushtonJL, FantKE, ClarkSJ. Use of practice guidelines in the primary care of children with attention-deficit/hyperactivity disorder. Pediatrics, e23:28. 2004.
39.
ScahillL, Schwab-StoneM. Epidemiology of ADHD in school-age children. Child Adolesc Psychiatric Clin North Am, 9:541–555. 2000.
40.
SchatzDB, RostainAL. ADHD with comorbid anxiety: A review of the current literature. J Atten Disord, 2:141–149. 2006.
41.
SeidmanLJ. Neuropsychological functioning in people with ADHD across the lifespan. Clin Psychol Rev, 26:466–485. 2006.
42.
SeidmanLJ, BiedermanJ, FaraoneSV. Impact of gender and age on executive functioning: Do girls and boys with and without attention deficit hyperactivity disorder differ neuropsychologically in preteen and teenage years?Develop Neuropsychol, 1:79–105. 2005.
43.
Sonuga-BarkeEJ, CoghillD, MarkowitzJS, SwansonJM, VandenbergheM, HatchSJ. Sex differences in the response of children with ADHD to once-daily formulations of methylphenidate. J Am Acad Child Adolesc Psychiatry, 6:701–710. 2007.
44.
SpikmanJM, KiersHA, DeelmanBG, VanZ, AdriaanH. Construct validity of concepts of attention in healthy controls and patients with CHI. Brain Cogn, 47:446–460. 2001.
45.
SpragueRL, Sleator EK. Methylphenidate in hyperkinetic children: Differences in dose effects on learning and social behavior. Science, 198:1274–1276. 1977.
46.
SzatmariP, OffordDR, BoyleMH. Ontario Child Health Study: Prevalence of attention deficit disorder with hyperactivity. J Child Psychol Psychiatry, 2:219–230. 1989.
47.
TabachnickBG, FidellLS. Using Multivariate Statistics, 4. New York: Allyn & Bacon, 2000.
48.
TannockR, SchacharR, LoganGD. Methylphenidate and cognitive flexibility: Dissociated dose effects in hyperactive children. J Abnorm Child Psychol, 23:235–266. 1995.
TewesU, SchallbergerU, RossmannK. Hamburg Wechsler Intelligenztest für Kinder III. Göttingen: Hogrefe, 1999.
51.
TuchaO, PrellS, MecklingerL, Bormann-KischkelC, KubberS, LinderM, WalitzaS, LangeKW. Effects of methylphenidate on multiple components of attention in children with attention deficit hyperactivity disorder. Psychopharmacology (Berl), 3:315–326. 2006.
52.
UnnewehrS, SchneiderS, MargrafJ. Kinder DIPS—Diagnostisches Interview bei psychischen Störungen im Kindes und Jugendalter. Heidelberg: Springer, 1995.
53.
Van der MeereJ, MarzocchiGM, De MeoT. Response inhibition and attention deficit hyperactivity disorder with and without oppositional defiant disorder screened from a community sample. Develop Neuropsychol, 1:459–472. 2005.
54.
Van ZomerenAH, BrouwerW. J.Theories and Concepts of Attention. Van-ZomerenAH, BrouwerW. J.Clinical Neuropsychology of Attention (2)New York: Oxford: Oxford University Press, 1994; 7–38.
55.
WillcuttEG, PenningtonBF. Comorbidity of reading disability and attention-deficit/hyperactivity disorder: differences by gender and subtype. J Learn Disabil, 2:179–191. 2000.
56.
WodkaEL, MostofskySH, PrahmeC, Gidley LarsonJC, LoftisC, DencklaMB, Mark MahoneE. Process examination of executive function in ADHD: Sex and subtype effects. Clin Neuropsycholog, 5:826–841. 2008.
