Abstract
Objective: The construct of Sluggish Cognitive Tempo (SCT) is characterized by daydreaming, mental confusion, staring blankly and hypoactivity. Our main goal was to explore neuropsychological differences in Attention Deficit Hyperactivity Disorder-Inattentive presentation (ADHD-IA) groups with and without SCT symptoms compared to healthy controls. After detecting specific neuropsychological differences, we examined white matter microstructure using Diffusion Tensor Imaging (DTI) data obtained from 3.0 Tesla MRI scans of the cases with SCT symptoms comparing to Typically Developing (TD) controls.
Method: In this study, we included 24 cases in the ADHD-IA group with SCT symptoms, 57 cases in the ADHD-IA group without SCT symptoms and, 24 children in the TD group. We applied tract-based spatial statistics to the DTI measures for obtaining fractional anisotropy (FA), axial, radial and mean diffusivity (AD, RD, MD) to explore white matter differences for the whole brain.
Results: Omission error scores and longer reaction time scores were specifically associated with inattention symptoms. Commission error scores were significantly and specifically related to SCT symptoms. Cases with SCT symptoms presented increased FA in the bilateral anterior and posterior limb of the internal capsule, bilateral cerebral peduncle, and the fornix than TD group.
Conclusions: Neurobiological differences in ADHD cases are still relatively unexplored. We suggest that including an assessment for SCT in the neuropsychological and neuroimaging studies of ADHD may provide more consistent results.
Acknowledgement
We would like to express our very grate appreciation to Professor Russell A. Barkley.
Disclosure statement
Eyüp Sabri Ercan is on advisory boards for Abdi İbrahim Otsuka Turkey, Ali Raif Medicine Turkey and Sanofi Turkey. The other authors declare that they have no conflict of interest.
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Notes on contributors
Gül Ünsel-Bolat
Gül Ünsel-Bolat is MD at Child and Adolescent Psychiatry Department of Balıkesir University and PhD candidate in Neuroscience since 2018 at Ege University.
Muharrem Burak Baytunca
Muharrem Burak Baytunca provided MD degree at Child and Adolescent Psychiatry Department of Ege University and is currently resident at Psychiatry Department of Utah University since 2019.
Burcu Kardaş
Burcu Kardaş is MD at Child and Adolescent Psychiatry Department of Gazi Yaşargil Education and Research Hospital.
Melis İpçi
Melis İpçi is BS at Clinical Psychology Department of Hasan Kalyoncu University.
Sevim Berrin İnci İzmir
Sevim Berrin İnci İzmir is MSc at Clinical Psychology Department of Işık University.
Onur Özyurt
Onur Özyurt is PhD at Biomedical Engineering Department of Boğaziçi University.
Mehmet Cem Çallı
Mehmet Cem Çallı is MD and Professor at Radiology Department of Ege University.
Eyüp Sabri Ercan
Eyüp Sabri Ercan is MD and Professor at Child and Adolescent Psychiatry Department of Ege University.