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Highlights • Sluggish cognitive tempo comorbid ADHD subjects possess several distinct neuropsychological differences in comparison to ADHD-only counterparts. • Cognitive flexibility, attentional set shifting and sustained attention were found to be more impaired in SCT comorbid ADHD subjects. • SCT was not found to be associated with auditory/visual memory, reaction time, psychomotor speed. • These findings indicate that SCT might be a disorder of vigilance/arousal system rather than executive functions. Abstract Sluggish Cognitive Tempo (SCT) refers to a clinical construct including several symptoms such as sluggishness, absentmindedness, low energy. In the present study, we compared neurocognitive laboratory outcomes of ADHD children with or without SCT. Method: The CNS Vital Signs Battery was utilized to measure neurocognitive measure of the participants. The SCT+ADHD group comprised of 42 subjects, ADHD group was 41 subjects and control group was 24 subjects. Results: The cognitive flexibility score was found to be more severely impaired in ADHD children with SCT in comparison to the ADHD-only. Additionally, greater deficits in the Shifting Attention Test (p = 0.014) and the Continuous Performance Test (reaction time score, p < 0.01) were found in the SCT+ADHD group relative to ADHD group. Processing speed, visual/auditory memory, psychomotor speed and reaction time were not found to more impaired in those comorbid with SCT. Conclusion: Impairments in the cognitive flexibility and more specifically shifting attention and continuous performance may be indicative of vigilance and orientation problems rather than executive functions for the SCT construct. [ABSTRACT FROM AUTHOR]

Objective: Risperidone long-acting injection (RLAI) was shown to be an alternative option in adult patients, but there is not available data in child and adolescents about this medication. The aim of this study is to evaluate the safety and efficiency profile of RLAI in a group of adolescents. Methods: Eleven cases with conduct disorder and severe aggressive behaviors were initiated treatment with risperidone oral form. All cases were then shifted to RLAI 25 mg injection in each 15 days due to poor compliance to oral risperidone treatment. Efficiency of treatment included indicators of clinical severity and improvement, which were evaluated by Clinical Global Impression-Severity (CGI-S) and Improvement (CGI-I). Safety evaluation was performed by using Extrapyramidal Symptoms Rating Scale, and by monitoring body weight. Follow-up visits were done at the treatment initiation, and 8th, 16th, and 24th weeks of first injection. Results: Study included 9 girls, and 2 boys, with a mean age of 14.9±1.0 years. The CGI-S scores decreased from 6.6±0.5 at the beginning to 2.2±1.1 at the last visit (p<0.001), which is a very significant decrease through better clinical level. The CGI-I scores were also improved significantly from 2.4±0.5 to 1.9±0.5 at 24th week (p=0.001). Safety parameters were also showed favorable results, which there was no significant weight gain (p=0.076), and well-tolerated extrapyramidal adverse effects. Conclusion: Our results showed that RLAI is an efficient and safe medication option in the treatment of psychiatric disorders and severe behavioral problems in adolescents with low-compliance to oral treatment in our cases. [ABSTRACT FROM AUTHOR]

Arterial spin labeling (ASL) is a relatively new imaging modality in the field of the cognitive neuroscience. In the present study, we aimed to compare the dynamic regional cerebral blood flow alterations of children with ADHD and healthy controls during a neurocognitive task by using event-related ASL scanning. The study comprised of 17 healthy controls and 20 children with ADHD. The study subjects were scanned on 3 Tesla MRI scanner to obtain ASL imaging data. Subjects performed go/no-go task during the ASL image acquisition. The image analyses were performed by FEAT (fMRI Expert Analysis Tool) Version 6. The mean age was 10.88 ± 1.45 and 11 ± 1.91 for the control and ADHD group, respectively (p =.112). The go/no-go task was utilized during the ASL scanning. The right anterior cingulate cortex (BA32) extending into the frontopolar and orbitofrontal cortices (BA10 and 11) displayed greater activation in ADHD children relative to the control counterparts (p <.001). With a lenient significance threshold, greater activation was revealed in the right-sided frontoparietal regions during the go session, and in the left precuneus during the no-go session. These results indicate that children with ADHD needed to over-activate frontopolar cortex, anterior cingulate as well as the dorsal and ventral attention networks to compensate for the attention demanded in a given cognitive task. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the aripiprazole augmentation of selective seratonine reuptake inhibitors (SSRIs) in children and adolescents with treatment-resistant OCD. Forty-eight children and adolescents (14 girls, 34 boys), who are non-responders to treatment with at least two types of SSRIs and CBT, were administered a 12-week of augmentation. Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and Clinical Global Impression-Severity and Improvement (CGI-S and CGI-I) sub-scales were used for evaluation of the treatment outcomes. The results showed that total CY-BOCS scores were decreased from 33.3 ± 7.5 to 11.7 ± 9.3 (p < 0.001), CGI-S scores decreased from 6.3 ± 0.9 to 2.7 ± 1.6 (p < 0.001), and CGI-I scores improved from 4.3 ± 0.6 to 2.2 ± 1.1 (p < 0.001). Sensitivity analyses in 29 patients without SSRI dose escalation along with aripiprazole augmentation have also revealed that improvement effect was still significant, and CY-BOCS scores were improved from 34.2 ± 7.9 to 13 ± 10.3, CGI-S improved from 6.4 ± 1.0 to 3.0 ± 1.7, and CGI-I improved from 4.4 ± 1.0 to 2.3 ± 1.1 (p < 0.001 for all). Analyses revealed that a significant clinical improvement has been observed with aripiprazole augmentation. Aripiprazole augmentation of SSRIs is a promising strategy in the management of treatment-refractory OCD children and adolescents. [ABSTRACT FROM AUTHOR]