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Neuropsychological analyses of impulsiveness in childhood hyperactivity

K. RUBIA, PhD, E. TAYLOR, FRCPsych, A. B. SMITH, PhD, H. OKSANNEN, MSc, S. OVERMEYER, MD and S. NEWMAN, BSc MRC
Child and Adolescent Psychiatry Unit, Institute of Psychiatry, King's College, London
Correspondence: Dr Katya Rubia, MRC Child and Adolescent Psychiatry Unit, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Tel: +44(0)20 7848 0463; fax: +44(0)20 7705 5800;
e-mail: k.rubia@iop.kcl.ac.uk

The British Journal of Psychiatry (2001) 179: 138-143
2001 The Royal College of Psychiatrists
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Declaration of interest
The study was supported by a grant from the Wellcome Trust and the Medical Research Council.

ABSTRACT

Background Neuropsychological analyses of impulsiveness are needed to refine assessment of attention-deficit hyperactivity disorder (ADHD).

Aims To investigate specific impairments in hyperactive children in a neuropsychological task battery of impulsiveness, the Maudsley Attention and Response Suppression (MARS) task battery, and to identify the neural substrates.

Method Impulsiveness was assessed using different tasks of inhibitory control and time management (MARS) in 55 children with ADHD, other diagnoses and controls. Functional magnetic resonance images were obtained from adolescents with and without ADHD during three of the tasks.

Results Children with ADHD, but not psychiatric controls, were impaired on tests of response inhibition, but not of motor timing. Reduced right prefrontal activation was observed in hyperactive adolescents during higher level inhibition and delay management, but not during simple sensorimotor coordination.

Conclusions Attention-deficit hyperactivity disorder is characterised by specific deficits in tasks of motor response inhibition, but not motor timing, and by dysfunction of frontostriatal brain regions.

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