human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Neural correlates of emotional dysregulation in attention-deficit/hyperactivity disorder ( ADHD ) and persisting influence of Methylpheni date ( MPH ) still remain insufficiently understood . Decreased activation in the subgenual cingulate and the ventral striatum were found during the perception of positive and negative affective pictures in drug-naïve males with ADHD during childhood ( n=10 ) . Males with ADHD during childhood treated with MPH ( n=10 ) did not show any significant differences compared to healthy controls ( n=10 ) . Further prospect i ve studies need to clarify direct and indirect mechanisms of MPH treatment that may contribute to emotional processing , which is dysfunctional in males without pharmacological treatment in childhood OBJECTIVE To determine response of low-IQ children with attention deficit hyperactivity disorder ( ADHD ) symptoms to methylpheni date ( MPH ) . METHODS An aggregated analysis was conducted in 90 children with low IQ who received the same dose regimen of MPH in three independent , placebo-controlled studies . Active drug and placebo were given from 2 to 4 weeks each . Outcome measures included teacher and parent ratings on st and ardized behavior scales ( mean n = 84 ) , performance on computer-controlled cognitive-motor tests ( n = 62 ) , and measures of cardiovascular response ( n = 85 ) . RESULTS Both teachers and parents rated the children consistently as being improved on subscales assessing attention , overactivity , and conduct problems . Some 44 % of the subjects showed at least a 30 % reduction compared with placebo on teacher ratings . MPH  improved accuracy on several cognitive tests , response speed was increased on some , and seat activity declined for one of three tests ; heart rate was mildly increased ( 3.9 beats/minute ) with MPH . Analyses of IQ and mental age as moderator variables suggested that lower functional level ( especially lower IQ ) may be associated with a less favorable response to MPH . CONCLUSIONS Children with low IQ and ADHD clearly respond to MPH , but their rate of beneficial response appears to be well under that of normal-IQ children and more varied . Different attentional mechanisms may moderate response to psychostimulants Sixty-nine children with attention deficit hyperactivity disorder ( ADHD ) underwent blind methylpheni date trials . 36 had ADHD alone ( with or without a learning disability ) and 33 had additional neurodevelopmental disorders . Of the children with ADHD alone , 88 per cent improved significantly on methylpheni date . This did not differ significantly from the 69 per cent response rate for children with ADHD and other neurodevelopmental disorders . The results confirm and add to the research literature indicating that ADHD children who are of preschool age and /or who have co-existing neurological disorders may benefit from methylpheni date This report examined the effect of methylpheni date on social communication and self-regulation in children with pervasive developmental disorders and hyperactivity in a secondary analysis of RUPP Autism Network data . Participants were 33 children ( 29 boys ) between the ages of 5 and 13 years who participated in a four-week crossover trial of placebo and increasing doses of methylpheni date given in r and om order each for one week . Observational measures of certain aspects of children ’s social communication , self-regulation , and affective behavior were obtained each week . A significant positive effect of methylpheni date was seen on children ’s use of joint attention initiations , response to bids for joint attention , self-regulation , and regulated affective state . The results go beyond the recent literature and suggest that methylpheni date may have positive effects on social behaviors in children with PDD and hyperactivity A double-blind , placebo-controlled , crossover study of methylpheni date ( 0.4 mg/kgday ) and different doses of fenfluramine ( 1.0 , 1.5 , or 2.0 mg/g/day ) in children with mental retardation or borderline IQ and ADHD was conducted . Parents , teachers , examiners , and physicians rated the children . There were relatively few significant drug effects by condition . When the optimal fenfluramine dose for each child was compared with placebo and methylpheni date , significant improvements occurred for fenfluramine on several parent and teacher subscales ; teachers rated the children as somewhat improved with methylpheni date . The highest dose of fenfluramine produced more behavior compliance but apparently at the cost of cognitive efficiency . Most side effects ( drowsiness , dizziness , anorexia ) occurred with fenfluramine . Both drugs appear to be effective treatments for children with ADHD and mental retardation , although there is a possible neurotoxic action with fenfluramine . We recommend a gradual phase-in of fenfluramine dosage , up to 1.5 mg/kg/day , for most children CONTEXT Hyperactivity and inattention are common symptoms in children with autistic disorder and related pervasive developmental disorders , but studies of stimulants in these conditions have been inconclusive . OBJECTIVES To determine the efficacy and safety of methylpheni date hydrochloride in children with pervasive developmental disorders and hyperactivity . DESIGN Double-blind , placebo-controlled , crossover trial followed by open-label continuation . SETTING Five academic outpatient clinics . PARTICIPANTS Seventy-two drug-free children , aged 5 to 14 years , with pervasive developmental disorders accompanied by moderate to severe hyperactivity . INTERVENTIONS Prior to r and omization , subjects entered a 1-week test-dose phase in which each subject received placebo for 1 day followed by increasing doses of methylpheni date ( low , medium , and high doses ) that were each given for 2 days . The low , medium , and high doses of methylpheni date hydrochloride were based on weight , and they ranged from 7.5 mg/d to 50.0 mg/d in divided doses . Subjects who tolerated the test dose ( n = 66 ) were assigned to receive placebo for 1 week and then 3 methylpheni date doses in r and om order during a double-blind , crossover phase . Children responding to methylpheni date then entered 8 weeks of open-label treatment at the individually determined best dose . MAIN OUTCOME MEASURES The primary outcome measure was the teacher-rated hyperactivity subscale of the Aberrant Behavior Checklist . Response was defined as " much improved " or " very much improved " on the Clinical Global Impressions Improvement item coupled with considerable reductions in the parent-rated and /or teacher-rated Aberrant Behavior Checklist hyperactivity subscale score . RESULTS Methylpheni date was superior to placebo on the primary outcome measure , with effect sizes ranging from 0.20 to 0.54 depending on dose and rater . Thirty-five ( 49 % ) of 72 enrolled subjects were classified as methylpheni date responders . Adverse effects led to the discontinuation of study medication in 13 ( 18 % ) of 72 subjects . CONCLUSIONS Methylpheni date was often efficacious in treating hyperactivity associated with pervasive developmental disorders , but the magnitude of response was less than that seen in typically developing children with attention-deficit/hyperactivity disorder . Adverse effects were more frequent BACKGROUND Methylpheni date has been shown elsewhere to improve hyperactivity in about half of treated children who have pervasive developmental disorders ( PDD ) and significant hyperactive-inattentive symptoms . We present secondary analyses to better define the scope of effects of methylpheni date on symptoms that define attention-deficit/hyperactivity disorder ( ADHD ) and oppositional defiant disorder ( ODD ) , as well as the core autistic symptom domain of repetitive behavior . METHODS Sixty-six children ( mean age 7.5 y ) with autistic disorder , Asperger 's disorder , and PDD not otherwise specified , were r and omized to varying sequences of placebo and three different doses of methylpheni date during a 4-week blinded , crossover study . Methylpheni date doses used approximated .125 , .25 , and .5 mg/kg per dose , twice daily , with an additional half-dose in the late afternoon . Outcome measures included the Swanson , Nolan , and Pelham Question naire revised for DSM-IV ( ADHD and ODD scales ) and the Children 's Yale-Brown Obsessive Compulsive Scales for PDD . RESULTS Methylpheni date was associated with significant improvement that was most evident at the .25- and .5-mg/kg doses . Hyperactivity and impulsivity improved more than inattention . There were not significant effects on ODD or stereotyped and repetitive behavior . CONCLUSIONS Convergent evidence from different assessment s and raters confirms methylpheni date 's efficacy in relieving ADHD symptoms in some children with PDD . Optimal dose analyses suggested significant interindividual variability in dose response CONTEXT To our knowledge , there is no published information on the epidemiology of autism spectrum disorders ( ASDs ) in adults . If the prevalence of autism is increasing , rates in older adults would be expected to be lower than rates among younger adults . OBJECTIVE To estimate the prevalence and characteristics of adults with ASD living in the community in Engl and . DESIGN A stratified , multiphase r and om sample was used in the third national survey of psychiatric morbidity in adults in Engl and in 2007 . Survey data were weighted to take account of study design and nonresponse so that the results were representative of the household population . SETTING General community ( ie , private households ) in Engl and . PARTICIPANTS Adults ( people 16 years or older ) . MAIN OUTCOME MEASURES Autism Diagnostic Observation Schedule , Module 4 in phase 2 vali date d against the Autism Diagnostic Interview-Revised and Diagnostic Interview for Social and Communication Disorders in phase 3 . A 20-item subset of the Autism-Spectrum Quotient self-completion question naire was used in phase 1 to select respondents for phase 2 . Respondents also provided information on sociodemographics and their use of mental health services . RESULTS Of 7461 adult participants who provided a complete phase 1 interview , 618 completed phase 2 diagnostic assessment s. The weighted prevalence of ASD in adults was estimated to be 9.8 per 1000 ( 95 % confidence interval , 3.0 - 16.5 ) . Prevalence was not related to the respondent 's age . Rates were higher in men , those without educational qualifications , and those living in rented social ( government-financed ) housing . There was no evidence of increased use of services for mental health problems . CONCLUSIONS Conducting epidemiologic research on ASD in adults is feasible . The prevalence of ASD in this population is similar to that found in children . The lack of an association with age is consistent with there having been no increase in prevalence and with its causes being temporally constant . Adults with ASD living in the community are socially disadvantaged and tend to be unrecognized Twenty-six children having Attention Deficit Hyperaclivity Disorder were tested before and after treatment with methylpheni date . In addition to st and ardized parent and teacher rating scales , each child was assessed on a variety of psychomotor tests with an emphasis on attentional constructs . Relatively few of the performance tests , administered prior to medication , predicted clinical response to medication . However , chronological age and performance on a  memory distraction task and on the Graduated Holes Task ( Kløve , 1963 ) were moderately correlated with clinical outcome . Using stepwise multiple regression analyses to predict outcome , age and the psychomotor tasks predicted about 50 % of outcome variance . There was virtually no relationship between clinical change and change on the performance tests . Findings are discussed with respect to results from previous prediction studies , theoretical models of drug response , and clinical management This study examined the effects of methylpheni date ( MPH ) on reaction time ( RT ) variability in children with attention deficit hyperactivity disorder ( ADHD ) . Using a broad battery of computerized tasks , and both conventional and ex-Gaussian indicators of RT variability , in addition to within-task manipulations of incentive and event rate ( ER ) , this study comprehensively examined the breadth , specificity , and possible moderators of effects of MPH on RT variability .  A total of 93 children with ADHD completed a 4-week within-subject , r and omized , double-blind , placebo-controlled crossover trial of MPH to identify an optimal dosage . Children were then r and omly assigned to receive either their optimal MPH dose or placebo after which they completed five neuropsychological tasks , each allowing trial-by-trial assessment of RTs . Stimulant effects on RT variability were observed on both measures of the total RT distribution ( ie , coefficient of variation ) as well as on an ex-Gaussian measure examining the exponential portion of the RT distribution ( ie , τ ) . There was minimal , if any , effect of MPH  on performance accuracy or RT speed . Within-task incentive and ER manipulations did not appreciably affect stimulant effects across the tasks . The pattern of significant and pervasive effects of MPH on RT variability , and few effects of MPH  on accuracy and RT speed suggest that MPH primarily affects RT variability . Given the magnitude and breadth of effects of MPH on RT variability as well as the apparent specificity of these effects of MPH on RT variability indicators , future research should focus on neurophysiological correlates of effects of MPH on RT variability in an effort to better define MPH pharmacodynamics OBJECTIVE The aim of this study was to investigate the short-term efficacy and safety of methylpheni date ( MPH ) to treat attention-deficit/hyperactivity disorder ( ADHD ) symptoms in an understudied population of preschoolers with pervasive developmental disorder ( PDD ) or intellectual disability ( ID ) . METHO 
    Output:
    
agent
No trials reported serious adverse events .
Subgroup analysis by dose did not identify any significant differences in effect on our primary outcomes between low- , medium- or high-dose ranges .
We found that short-term use of methylpheni date might improve symptoms of hyperactivity and possibly inattention in children with ASD who are tolerant of the medication , although the low quality of evidence means that we can not be certain of the true magnitude of any effect .
There was no evidence that methylpheni date has a negative impact on the core symptoms of ASD , or that it improves social interaction , stereotypical behaviours , or overall ASD .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Neural correlates of emotional dysregulation in attention-deficit/hyperactivity disorder ( ADHD ) and persisting influence of Methylpheni date ( MPH ) still remain insufficiently understood . Decreased activation in the subgenual cingulate and the ventral striatum were found during the perception of positive and negative affective pictures in drug-naïve males with ADHD during childhood ( n=10 ) . Males with ADHD during childhood treated with MPH ( n=10 ) did not show any significant differences compared to healthy controls ( n=10 ) . Further prospect i ve studies need to clarify direct and indirect mechanisms of MPH treatment that may contribute to emotional processing , which is dysfunctional in males without pharmacological treatment in childhood OBJECTIVE To determine response of low-IQ children with attention deficit hyperactivity disorder ( ADHD ) symptoms to methylpheni date ( MPH ) . METHODS An aggregated analysis was conducted in 90 children with low IQ who received the same dose regimen of MPH in three independent , placebo-controlled studies . Active drug and placebo were given from 2 to 4 weeks each . Outcome measures included teacher and parent ratings on st and ardized behavior scales ( mean n = 84 ) , performance on computer-controlled cognitive-motor tests ( n = 62 ) , and measures of cardiovascular response ( n = 85 ) . RESULTS Both teachers and parents rated the children consistently as being improved on subscales assessing attention , overactivity , and conduct problems . Some 44 % of the subjects showed at least a 30 % reduction compared with placebo on teacher ratings . MPH  improved accuracy on several cognitive tests , response speed was increased on some , and seat activity declined for one of three tests ; heart rate was mildly increased ( 3.9 beats/minute ) with MPH . Analyses of IQ and mental age as moderator variables suggested that lower functional level ( especially lower IQ ) may be associated with a less favorable response to MPH . CONCLUSIONS Children with low IQ and ADHD clearly respond to MPH , but their rate of beneficial response appears to be well under that of normal-IQ children and more varied . Different attentional mechanisms may moderate response to psychostimulants Sixty-nine children with attention deficit hyperactivity disorder ( ADHD ) underwent blind methylpheni date trials . 36 had ADHD alone ( with or without a learning disability ) and 33 had additional neurodevelopmental disorders . Of the children with ADHD alone , 88 per cent improved significantly on methylpheni date . This did not differ significantly from the 69 per cent response rate for children with ADHD and other neurodevelopmental disorders . The results confirm and add to the research literature indicating that ADHD children who are of preschool age and /or who have co-existing neurological disorders may benefit from methylpheni date This report examined the effect of methylpheni date on social communication and self-regulation in children with pervasive developmental disorders and hyperactivity in a secondary analysis of RUPP Autism Network data . Participants were 33 children ( 29 boys ) between the ages of 5 and 13 years who participated in a four-week crossover trial of placebo and increasing doses of methylpheni date given in r and om order each for one week . Observational measures of certain aspects of children ’s social communication , self-regulation , and affective behavior were obtained each week . A significant positive effect of methylpheni date was seen on children ’s use of joint attention initiations , response to bids for joint attention , self-regulation , and regulated affective state . The results go beyond the recent literature and suggest that methylpheni date may have positive effects on social behaviors in children with PDD and hyperactivity A double-blind , placebo-controlled , crossover study of methylpheni date ( 0.4 mg/kgday ) and different doses of fenfluramine ( 1.0 , 1.5 , or 2.0 mg/g/day ) in children with mental retardation or borderline IQ and ADHD was conducted . Parents , teachers , examiners , and physicians rated the children . There were relatively few significant drug effects by condition . When the optimal fenfluramine dose for each child was compared with placebo and methylpheni date , significant improvements occurred for fenfluramine on several parent and teacher subscales ; teachers rated the children as somewhat improved with methylpheni date . The highest dose of fenfluramine produced more behavior compliance but apparently at the cost of cognitive efficiency . Most side effects ( drowsiness , dizziness , anorexia ) occurred with fenfluramine . Both drugs appear to be effective treatments for children with ADHD and mental retardation , although there is a possible neurotoxic action with fenfluramine . We recommend a gradual phase-in of fenfluramine dosage , up to 1.5 mg/kg/day , for most children CONTEXT Hyperactivity and inattention are common symptoms in children with autistic disorder and related pervasive developmental disorders , but studies of stimulants in these conditions have been inconclusive . OBJECTIVES To determine the efficacy and safety of methylpheni date hydrochloride in children with pervasive developmental disorders and hyperactivity . DESIGN Double-blind , placebo-controlled , crossover trial followed by open-label continuation . SETTING Five academic outpatient clinics . PARTICIPANTS Seventy-two drug-free children , aged 5 to 14 years , with pervasive developmental disorders accompanied by moderate to severe hyperactivity . INTERVENTIONS Prior to r and omization , subjects entered a 1-week test-dose phase in which each subject received placebo for 1 day followed by increasing doses of methylpheni date ( low , medium , and high doses ) that were each given for 2 days . The low , medium , and high doses of methylpheni date hydrochloride were based on weight , and they ranged from 7.5 mg/d to 50.0 mg/d in divided doses . Subjects who tolerated the test dose ( n = 66 ) were assigned to receive placebo for 1 week and then 3 methylpheni date doses in r and om order during a double-blind , crossover phase . Children responding to methylpheni date then entered 8 weeks of open-label treatment at the individually determined best dose . MAIN OUTCOME MEASURES The primary outcome measure was the teacher-rated hyperactivity subscale of the Aberrant Behavior Checklist . Response was defined as " much improved " or " very much improved " on the Clinical Global Impressions Improvement item coupled with considerable reductions in the parent-rated and /or teacher-rated Aberrant Behavior Checklist hyperactivity subscale score . RESULTS Methylpheni date was superior to placebo on the primary outcome measure , with effect sizes ranging from 0.20 to 0.54 depending on dose and rater . Thirty-five ( 49 % ) of 72 enrolled subjects were classified as methylpheni date responders . Adverse effects led to the discontinuation of study medication in 13 ( 18 % ) of 72 subjects . CONCLUSIONS Methylpheni date was often efficacious in treating hyperactivity associated with pervasive developmental disorders , but the magnitude of response was less than that seen in typically developing children with attention-deficit/hyperactivity disorder . Adverse effects were more frequent BACKGROUND Methylpheni date has been shown elsewhere to improve hyperactivity in about half of treated children who have pervasive developmental disorders ( PDD ) and significant hyperactive-inattentive symptoms . We present secondary analyses to better define the scope of effects of methylpheni date on symptoms that define attention-deficit/hyperactivity disorder ( ADHD ) and oppositional defiant disorder ( ODD ) , as well as the core autistic symptom domain of repetitive behavior . METHODS Sixty-six children ( mean age 7.5 y ) with autistic disorder , Asperger 's disorder , and PDD not otherwise specified , were r and omized to varying sequences of placebo and three different doses of methylpheni date during a 4-week blinded , crossover study . Methylpheni date doses used approximated .125 , .25 , and .5 mg/kg per dose , twice daily , with an additional half-dose in the late afternoon . Outcome measures included the Swanson , Nolan , and Pelham Question naire revised for DSM-IV ( ADHD and ODD scales ) and the Children 's Yale-Brown Obsessive Compulsive Scales for PDD . RESULTS Methylpheni date was associated with significant improvement that was most evident at the .25- and .5-mg/kg doses . Hyperactivity and impulsivity improved more than inattention . There were not significant effects on ODD or stereotyped and repetitive behavior . CONCLUSIONS Convergent evidence from different assessment s and raters confirms methylpheni date 's efficacy in relieving ADHD symptoms in some children with PDD . Optimal dose analyses suggested significant interindividual variability in dose response CONTEXT To our knowledge , there is no published information on the epidemiology of autism spectrum disorders ( ASDs ) in adults . If the prevalence of autism is increasing , rates in older adults would be expected to be lower than rates among younger adults . OBJECTIVE To estimate the prevalence and characteristics of adults with ASD living in the community in Engl and . DESIGN A stratified , multiphase r and om sample was used in the third national survey of psychiatric morbidity in adults in Engl and in 2007 . Survey data were weighted to take account of study design and nonresponse so that the results were representative of the household population . SETTING General community ( ie , private households ) in Engl and . PARTICIPANTS Adults ( people 16 years or older ) . MAIN OUTCOME MEASURES Autism Diagnostic Observation Schedule , Module 4 in phase 2 vali date d against the Autism Diagnostic Interview-Revised and Diagnostic Interview for Social and Communication Disorders in phase 3 . A 20-item subset of the Autism-Spectrum Quotient self-completion question naire was used in phase 1 to select respondents for phase 2 . Respondents also provided information on sociodemographics and their use of mental health services . RESULTS Of 7461 adult participants who provided a complete phase 1 interview , 618 completed phase 2 diagnostic assessment s. The weighted prevalence of ASD in adults was estimated to be 9.8 per 1000 ( 95 % confidence interval , 3.0 - 16.5 ) . Prevalence was not related to the respondent 's age . Rates were higher in men , those without educational qualifications , and those living in rented social ( government-financed ) housing . There was no evidence of increased use of services for mental health problems . CONCLUSIONS Conducting epidemiologic research on ASD in adults is feasible . The prevalence of ASD in this population is similar to that found in children . The lack of an association with age is consistent with there having been no increase in prevalence and with its causes being temporally constant . Adults with ASD living in the community are socially disadvantaged and tend to be unrecognized Twenty-six children having Attention Deficit Hyperaclivity Disorder were tested before and after treatment with methylpheni date . In addition to st and ardized parent and teacher rating scales , each child was assessed on a variety of psychomotor tests with an emphasis on attentional constructs . Relatively few of the performance tests , administered prior to medication , predicted clinical response to medication . However , chronological age and performance on a  memory distraction task and on the Graduated Holes Task ( Kløve , 1963 ) were moderately correlated with clinical outcome . Using stepwise multiple regression analyses to predict outcome , age and the psychomotor tasks predicted about 50 % of outcome variance . There was virtually no relationship between clinical change and change on the performance tests . Findings are discussed with respect to results from previous prediction studies , theoretical models of drug response , and clinical management This study examined the effects of methylpheni date ( MPH ) on reaction time ( RT ) variability in children with attention deficit hyperactivity disorder ( ADHD ) . Using a broad battery of computerized tasks , and both conventional and ex-Gaussian indicators of RT variability , in addition to within-task manipulations of incentive and event rate ( ER ) , this study comprehensively examined the breadth , specificity , and possible moderators of effects of MPH on RT variability .  A total of 93 children with ADHD completed a 4-week within-subject , r and omized , double-blind , placebo-controlled crossover trial of MPH to identify an optimal dosage . Children were then r and omly assigned to receive either their optimal MPH dose or placebo after which they completed five neuropsychological tasks , each allowing trial-by-trial assessment of RTs . Stimulant effects on RT variability were observed on both measures of the total RT distribution ( ie , coefficient of variation ) as well as on an ex-Gaussian measure examining the exponential portion of the RT distribution ( ie , τ ) . There was minimal , if any , effect of MPH  on performance accuracy or RT speed . Within-task incentive and ER manipulations did not appreciably affect stimulant effects across the tasks . The pattern of significant and pervasive effects of MPH on RT variability , and few effects of MPH  on accuracy and RT speed suggest that MPH primarily affects RT variability . Given the magnitude and breadth of effects of MPH on RT variability as well as the apparent specificity of these effects of MPH on RT variability indicators , future research should focus on neurophysiological correlates of effects of MPH on RT variability in an effort to better define MPH pharmacodynamics OBJECTIVE The aim of this study was to investigate the short-term efficacy and safety of methylpheni date ( MPH ) to treat attention-deficit/hyperactivity disorder ( ADHD ) symptoms in an understudied population of preschoolers with pervasive developmental disorder ( PDD ) or intellectual disability ( ID ) . METHO 
    Output:
    