attention problems

Computer-based program may help ADHD symptoms in children

January, 2011

A five-week training program to improve working memory has significantly improved working memory, attention, and organization in many children and adolescents with ADHD.

A working memory training program developed to help children with ADHD has been tested by 52 students, aged 7 to 17. Between a quarter and a third of the children showed significant improvement in inattention, overall number of ADHD symptoms, initiation, planning/organization, and working memory, according to parental ratings. While teacher ratings were positive, they did not quite reach significance. It is worth noting that this improvement was maintained at the four-month follow-up.

The children used the software in their homes, under the supervision of their parents and the researchers. The program includes a set of 25 exercises in a computer-game format that students had to complete within 5 to 6 weeks. For example, in one exercise a robot will speak numbers in a certain order, and the student has to click on the numbers the robot spoke, on the computer screen, in the opposite order. Each session is 30 to 40 minutes long, and the exercises become progressively harder as the students improve.

The software was developed by a Swedish company called Cogmed in conjunction with the Karolinska Institute. Earlier studies in Sweden have been promising, but this is the first study in the United States, and the first to include children on medication (60% of the participants).

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Cognitive effects of heavy alcohol and marijuana use in adolescents

November, 2010

Alcohol and marijuana abuse associated with specific cognitive impairments in adolescents, but more surprisingly family history of substance abuse can also have an effect.

A study involving 48 adolescents, of whom 19 had been diagnosed with substance abuse/dependence, and 14 had a family history of substance abuse but no history of personal use, has found that greater alcohol use was associated with a significant decrease in attention and executive function (which is involved in planning and decision-making), while greater marijuana use was associated with poorer memory. Adolescents in the substance abuse group had lower scores in attention, memory, and processing speed, compared to the other groups, while those with a family history of abuse (but no personal history) had poorer visuospatial ability.

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Fetal alcohol exposure associated with a decrease in cognitive performance

November, 2010

Fetal exposure to large amounts of alcohol is found to be associated with reduced cognitive efficiency in perception, attention and recognition memory, in older children.

Data from 217 children from Inuit communities in Arctic Quebec (average age 11), of whom some had mothers that reported binge drinking during pregnancy, has revealed that the alcohol-exposed group, while similar to the control in accuracy and reaction time, showed a significant differences in their brains’ electrical activity while doing those tasks (a Go/No-go response inhibition task and a continuous recognition memory task). The differences suggest that fetal alcohol exposure is associated with reduced efficiency in the initial extracting of the meaning of a stimulus, reduced allocation of attention to the task, and poorer conscious recognition memory processing.

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Extraverts more vulnerable to effects of sleep deprivation after social interaction

November, 2010

A small study suggests that social activities are more tiring for extraverts than introverts, and that this personality trait may influence the effect of sleep loss on attention.

A study involving 48 healthy adults aged 18-39 has found that extraverts who were deprived of sleep for 22 hours after spending 12 hours in group activities performed worse on a vigilance task that did those extraverts who engaged in the same activities on their own in a private room. Introverts were relatively unaffected by the degree of prior social interaction.

The researchers suggest that social interactions are cognitively complex experiences that may lead to rapid fatigue in brain regions that regulate attention and alertness, and (more radically) that introverts may have higher levels of cortical arousal, giving them greater resistance to sleep deprivation.

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Rupp TL; Killgore WDS; Balkin TJ. Socializing by day may affect performance by night: vulnerability to sleep deprivation is differentially mediated by social exposure in extraverts vs introverts. SLEEP 2010;33(11):1475-1485.

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Memory impairment more common in people with a history of cancer

November, 2010

A very large study has found everyday memory problems among middle-aged and elderly are more likely in those with a history of cancer.

Confirming earlier indications from small studies, a very large nationwide survey has found that people who have had cancer are 40% more likely to experience memory problems that interfere with daily functioning.

The U.S. study involved nearly 10,000 people aged 40 and older, of whom 1,305 (13.3%) reported they had cancer or a history of cancer. Of these, 14% answered yes to the question "Are you limited in any way because of difficulty remembering or because you experience periods of confusion?" Of those who did not have a history of cancer, 8% answered yes to this question.

The degree to which these memory problems are related to the treatment or to the cancer itself (or even perhaps to the experience of having cancer) is one that needs further investigation, but the researcher suggests the finding points to memory issues being more common among cancer sufferers than realized, and recommends that cognitive assessment should be a standard part of cancer treatment.

The study is noteworthy in including all cancers, rather than focusing on one. Nevertheless, I hope that we eventually see a published paper (these results were presented at conference) that also analyses the data in terms of different cancers, different treatments, and length of time since the cancer.

Earlier reports on ‘chemobrain’, and possible ways to help

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Results were presented at the Third AACR Conference on The Science of Cancer Health Disparities.

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When estrogen helps memory, and when it doesn’t

November, 2010

Recent rodent studies confirm attention and learning is more difficult for women when estrogen is high, but estrogen therapy can help menopausal women — if given during a critical window.

Recent rodent studies add to our understanding of how estrogen affects learning and memory. A study found that adult female rats took significantly longer to learn a new association when they were in periods of their estrus cycle with high levels of estrogen, compared to their ability to learn when their estrogen level was low. The effect was not found among pre-pubertal rats. The study follows on from an earlier study using rats with their ovaries removed, whose learning was similarly affected when given high levels of estradiol.

Human females have high estrogen levels while they are ovulating. These high levels have also been shown to interfere with women's ability to pay attention.

On the other hand, it needs to be remembered that estrogen therapy has been found to help menopausal and post-menopausal women. It has also been found to be detrimental. Recent research has suggested that timing is important, and it’s been proposed that a critical period exists during which hormone therapy must be administered if it is to improve cognitive function.

This finds some support in another recent rodent study, which found that estrogen replacement increased long-term potentiation (a neural event that underlies memory formation) in young adult rats with their ovaries removed, through its effects on NMDA receptors and dendritic spine density — but only if given within 15 months of the ovariectomy. By 19 months, the same therapy couldn’t induce the changes.

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Childhood cancer survivors show sustained benefit from common ADHD medication

October, 2010

Ritalin helps some survivors of childhood cancer with attention problems.

Many survivors of childhood cancer experience cognitive problems as a result of their treatment. The drug methylphenidate (marketed under several names, the best known of which is Ritalin) has previously been shown to help attention problems in such survivors in the short term. Now a new study demonstrates that it can also be of benefit in the long term.

The study tested attention, social skills and behavior in survivors who had been on the drug for a year, comparing them to a similar group of unmedicated survivors. Although the drug did not lead to a significant gain in measured academic skills in math, reading and spelling, many did show improvements to attention that put them back in the normal range.

Nevertheless, the results also emphasize the need for other approaches, given that many did not benefit from the drug, and some may not be good candidates for medical or other reasons. The treatment group included 35 survivors of brain tumors and 33 of acute lymphoblastic leukemia (ALL). Any who suffered from ADHD before their cancer were excluded from the study.

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Low grades in adolescence linked to dopamine genes

October, 2010

A large American study of middle- and high-school students has found lower academic performance in core subjects was associated with three dopamine gene variants

Analysis of DNA and lifestyle data from a representative group of 2,500 U.S. middle- and high-school students tracked from 1994 to 2008 in the National Longitudinal Study of Adolescent Health has revealed that lower academic performance was associated with three dopamine gene variants. Having more of the dopamine gene variants (three rather than one, say) was associated with a significantly lower GPA.

Moreover, each of the dopamine genes (on its own) was linked to specific deficits: there was a marginally significant negative effect on English grades for students with a specific variant in the DAT1 gene, but no apparent effect on math, history or science; a specific variant in the DRD2 gene was correlated with a markedly negative effect on grades in all four subjects; those with the deleterious DRD4 variant had significantly lower grades in English and math, but only marginally lower grades in history and science.

Precisely why these specific genes might impact academic performance isn’t known with any surety, but they have previously been linked to such factors as adolescent delinquency, working memory, intelligence and cognitive abilities, and ADHD, among others.

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White noise improves memory in inattentive schoolchildren

October, 2010

Adding to research suggesting type of background noise affects whether it impairs learning or not, a new study indicates white noise has different effects depending on whether the students have attention problems.

Five years ago I reported on a finding that primary school children exposed to loud aircraft noise showed impaired reading comprehension (see below). Now a small Norwegian study has found that playing white noise helped secondary school children with attention problems, but significantly impaired those who were normally attentive.

The adolescents were asked to remember as many items as possible from a list read out either in the presence or absence of white noise (78dB). The results were consistent with a computational model based on the concepts of stochastic resonance and dopamine related internal noise, postulating that a moderate amount of external noise would benefit individuals in hypodopaminergic states (such as those with ADHD). The results need to be verified with a larger group, but they do suggest a new approach to helping those with attention problems.

The previous study referred to involved 2844 children aged 9-10. The children were selected from primary schools located near three major airports — Schiphol in the Netherlands, Barajas in Spain, and Heathrow in the UK. Reading age in children exposed to high levels of aircraft noise was delayed by up to 2 months in the UK and by up to 1 month in the Netherlands for each 5 decibel change in noise exposure. On the other hand, road traffic noise did not have an effect on reading and indeed was unexpectedly found to improve recall memory. An earlier German study found children attending schools near the old Munich airport improved their reading scores and cognitive memory performance when the airport shut down, while children going to school near the new airport experienced a decrease in testing scores.

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Half-heard phone conversations reduce cognitive performance

September, 2010

A new study finds that overheard cell phone conversations are particularly distracting because we can't predict what will be said next.

Why are other people’s phone conversations so annoying? A new study suggests that hearing only half a conversation is more distracting than other kinds of conversations because we're missing the other side of the story and so can't predict the flow of the conversation. This finding suggests that driving a car might be impaired not only by the driver talking on the phone, but also by passengers talking on their phones.

It also tells us something about the way we listen to people talking — we’re actively predicting what the person is going to say next. This helps explain something I’ve always wondered about. Listen to people talking in a language you don’t know and you’re often amazed how fast they talk. See an audio recording of the soundwaves, and you’ll wonder how people know when one word starts and another begins. Understanding what people are saying is not as easy as we believe it is — it takes a lot of experience. An important part of that experience, it seems, is learning the patterns of people’s speech, so we can predict what’s going to come next.

The study showed that people overhearing cell phone conversations did more poorly on everyday tasks that demanded attention, than when overhearing both sides of a cell phone conversation, which resulted in no decreased performance. By controlling for other acoustic factors, the researchers demonstrated that it was the unpredictable information content of the half-heard conversation that was so distracting.

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Emberson, L.L., Lupyan, G., Goldstein, M.H. & Spivey, M.J. 2010. Overheard Cell-Phone Conversations: When Less Speech Is More Distracting Psychological Science first published on September 3, 2010 as doi:10.1177/0956797610382126

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