Attention deficit hyperactivity disorder and neurocognitive correlates after childhood stroke

We investigated the frequency and neurocognitive correlates of attention deficit hyperactivity disorder and traits of this disorder (ADHD0Traits) after childhood stroke and orthopedic diagnosis in medical controls. Twenty-nine children with focal stroke lesions and individually matched children with clubfoot or scoliosis were studied with standardized psychiatric, intellectual, academic, adaptive, executive, and motivation function assessments. Lifetime ADHD0Traits were significantly more common in stroke participants with no prestroke ADHD than in orthopedic controls (16028 vs. 7029; Fisher’s Exact p , .02). Lifetime ADHD0Traits in the orthopedic controls occurred exclusively in males with clubfoot (7013; 54%). Participants with current ADHD0Traits functioned significantly worse ( p , .005) than participants without current ADHD0Traits on all outcome measures. Within the stroke group, current ADHD0Traits was associated with significantly lower verbal IQ and arithmetic achievement ( p , .04), more nonperseverative errors ( p , .005), and lower motivation ( p , .004). A principal components analysis of selected outcome variables significantly associated with current ADHD0Traits revealed “impaired neurocognition” and “inattention-apathy” factors. The latter factor was a more consistent predictor of current ADHD 0Traits in regression analyses. These findings suggest that inattention and apathy are core features of ADHD0Traits after childhood stroke. This association may provide clues towards the understanding of mechanisms underlying the syndrome. (JINS, 2003, 9, 815‐829.)