Auditory Brainstem Response (ABR) and Cambridge Neuropsychological Test Automated Battery (CANTAB) as Objective Support in Diagnosing Childhood ADHD and ASD

Sammanfattning: AbstractBackgroundThere is a need for easily administered objective tests in neurodevelopmental disorders. We investigated the clinical utility for child and adolescent psychiatry of Auditory Brainstem Response (ABR) and Cambridge Neuropsychological Test Automated Battery (CANTAB) as support in diagnosing attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). MethodsThe thesis consists of four studies based on ABR and CANTAB. The patients (7-17 years old) were recruited from child and adolescent psychiatry outpatient clinics in Lund and Eslöv, in southern Sweden. The age and gender matched controls were recruited from schools in the same areas. All invited families agreed to participate.ABR: 63 females and 48 males with ADHD were compared to 26 females and 20 male controls. Furthermore 31 females and 27 males with ASD were compared to 24 females and 23 male controls. Patients were diagnosed according to the DSM-IV/DSM-5. The ABR consists of seven positive peaks (waves I–VII) derived from electrical activity in the brain that occur during 10 Ms following a sound stimulus recorded by five electrodes.CANTAB:112 children with ADHD and 95 controls performed five CANTAB tests: Stockings of Cambridge (SOC), Intra-Extra Dimensional Set Shift (IED), Spatial Working Memory (SWM), Stop Reaction Time (SRT), and Stop Signal Task (SST).ResultsABR: We found three aberrations in the young female ADHD group and three other aberrations in the young male ADHD group compared to controls, while one aberration was present in both genders. In the ASD study only one aberration was found compared to controls. CANTAB: Between-group differences were found in all CANTAB tests except one. With hierarchical multiple regression analysis a main effect of ADHD diagnosis without interaction with age were seen in all the tests except SOC where a significant interaction with age was found.ConclusionsThe results suggest that ABR and CANTAB can differentiate between typically developed children and children with ADHD or ASD. All our results are based on observed group differences and cannot at this stage be transferred to single individuals.