First International School On Mind, Brain And Education

2005 July 16-20

Vadaskert Child and Adolescent Psychiatry Clinic. HUNGARY

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Frontostriatal pathology in neurodevelopmental disorders
After the decade of the brain there is a new rapprochement between neurology and psychiatry, namely the emergence of neuropsychology as both a research and a clinical discipline. This rather new aspect in psychiatric diagnosis involves thinking in a continuum rather than in dichotomy. A pregnant example of this approach can be seen in different frontostriatal neuropsychiatric disorders such as attention deficit hyperactivity disorder (ADHD), Tourette syndrome (TS), or obsessive compulsive disorder (OCD), which can be considered as common and in some aspects similar childhood onset syndromes. In these disorders the deficit is connected to the frontal lobe and the frontostriatal circuits which regulate the active state of the organism, control the essential elements of the subject’s intentions, program and monitor complex forms of activity. These functions called executive functions. In abnormal cases -such as in ADHD and TS-, there is not a balanced equilibrium for the release of wanted and unwanted inhibition patterns. In spite of the different symptoms of these syndromes, there is a similar executive dysfunction deficit which would arises the possibility of similar origination of these child psychiatric disorders. A battery of neuropsychological tests (i.e. Wisconsin Card Sorting Test, Stroop Test, Trail Making Test) was administered to 51 TS, 74 ADHD, 28 OCD children and 43 aged and IQ matched controls. The patient groups were found to be significantly impaired in a wide range of executive domains comparing to the control group, but the pattern of this dysfunction was different. This could support the hypothesis of common neurodevelopmental features of these disorders. When considering the comobidites as well, we can also see, that more dysfunctions can be seen when ADHD is present, which could be a risk comorbidity factor.