Kazushi Hanada

Association between activity level and situational factors in children with attention deficit/hyperactivity disorder in elementary school

Abstract  The aim of this study was to determine whether the objective activity level of children with attention deficit/hyperactivity disorder (AD/HD) is associated with situational factors in elementary school. A total of 16 children with combined‐type AD/HD (13 boys, 3 girls) and 20 controls matched for age and gender participated in the study. All the participants wore the objective measurement of activity level for 1 week while attending elementary school. The average activity levels were calculated for the morning and afternoon classes. The classes were categorized into four types: (i) in‐seat classes, in which the participants were expected to learn quietly while sitting in their own seats; (ii) not‐in‐seat classes, in which the participants were not expected to sit in their seats; (iii) physical education classes; and (iv) lunch/recess periods. During the afternoon in‐seat classes, the children with AD/HD were significantly more active than the controls. However, no significant differences based on the group (children with AD/HD or controls) were observed during the other morning or afternoon classes. These findings indicate that in naturalistic settings where the effects of situational demands involving inhibition and the effect of fatigue overlapped, the children with AD/HD exhibited an activity level that was different from that exhibited by the controls. Differences in the activity levels of children with AD/HD and normal controls were identified using an objective measurement of activity level when two situational factors overlapped.

Quantitative evaluation of norcholesterol scintigraphy, CT attenuation value, and chemical-shift MR imaging for characterizing adrenal adenomas

ObjectiveThe objective of our study was to evaluate diagnostic ability and features of quantitative indices of three modalities: uptake rate on norcholesterol scintigraphy, computed tomography (CT) attenuation value, and fat suppression on chemical-shift magnetic resonance imaging (MRI) for characterizing adrenal adenomas.MethodsImage findings of norcholesterol scintigraphy, CT, and MRI were reviewed for 78 patients with functioning (n = 48) or nonfunctioning (n = 30) adrenal masses. The norcholesterol uptake rate, attenuation value on unenhanced CT, and suppression on in-phase to opposed-phase MRI were measured for adrenal masses.ResultsThe norcholesterol uptake rate, CT attenuation value, and MR suppression index showed the sensitivity of 60%, 82%, and 100%, respectively, for functioning adenomas of <2.0 cm, and 96%, 79%, and 67%, respectively, for those of ≥2.0 cm. A statistically significant correlation was observed between size and norcholesterol uptake, and between CT attenuation value and MR suppression index. Regarding norcholesterol uptake, the adenoma-to-contralateral gland ratio was significantly higher in cortisol releasing than in aldosterone-releasing adenomas.ConclusionsThe norcholesterol uptake rate was reliable for characterization of adenomas among adrenal masses of ≥2.0 cm. CT attenuation value and MR suppression index were well correlated with each other, and were useful regardless of mass size.

Regional cerebral blood flow in the assessment of major depression and Alzheimer's disease in the early elderly.

BackgroundAlzheimers disease and major depression are representative diseases that present forgetfulness and a depressive mood. It is often difficult to make a differential diagnosis between the two in the initial phase. AimTo evaluate the differential diagnosis method using regional cerebral blood flow patterns with a three-dimensional stereotactic surface projection technique. MethodsTwenty early-elderly patients with mild and moderate forgetfulness were studied. Among them, 10 were diagnosed as having major depression (the MD group) and the other 10 as having Alzheimers disease (the AD group). All patients underwent cerebral perfusion single photon emission computed tomography (SPECT) with [123I]iodoamphetamine. A z-score was calculated for each pixel of the cerebral surface. Twenty-one circular regions of interest (ROIs) were placed on the z-score map. The significance of the statistical difference in ROI values between the two groups was determined by using the two-sided Mann–Whitney U-test. ResultsThe z-scores for the lateral parietal, lateral temporal, bilateral precuneus and bilateral posterior cingulate gyrus were significantly reduced in the AD group compared with those in the MD group. The z-scores for the lateral frontal, left thalamus and bilateral medial frontal regions were significantly lower in the MD group than in the AD group. ConclusionOur study demonstrated a difference in regional cerebral blood flow patterns between the early elderly with Alzheimers disease and those with major depression. All patients were classified into the appropriate categories using discriminant analysis and z-scores of frontal and parietal regions. Brain perfusion SPECT was a useful tool for the differential diagnosis between Alzheimers disease and major depression.

Differentiation between attention-deficit/hyperactivity disorder and pervasive developmental disorders with hyperactivity on objective activity levels using actigraphs

Aims:  To clarify differences in objective activity levels between children with attention‐deficit/hyperactivity disorder (ADHD) and those with pervasive developmental disorders (PDD) and hyperactivity.