Timing Deficits in ADHD: Insights From the Neuroscience of Musical Rhythm

Rhythmic musical activities may strengthen connectivity between brain networks associated with aging-related deficits in timing and executive functions

Brain aging and common conditions of aging (e.g., hypertension) affect networks important in organizing information, processing speed and action programming (i.e., executive functions). Declines in these networks may affect timing and could have an impact on the ability to perceive and perform musical rhythms. There is evidence that participation in rhythmic musical activities may help to maintain and even improve executive functioning (near transfer), perhaps due to similarities in brain regions underlying timing, musical rhythm perception and production, and executive functioning. Rhythmic musical activities may present as a novel and fun activity for older adults to stimulate interacting brain regions that deteriorate with aging. However, relatively little is known about neurobehavioral interactions between aging, timing, rhythm perception and production, and executive functioning. In this review, we account for these brain-behavior interactions to suggest that deeper knowledge of overlapping brain regions associated with timing, rhythm, and cognition may assist in designing more targeted preventive and rehabilitative interventions to reduce age-related cognitive decline and improve quality of life in populations with neurodegenerative disease. Further research is needed to elucidate the functional relationships between brain regions associated with aging, timing, rhythm perception and production, and executive functioning to direct design of targeted interventions.

Global-Local Processing in ADHD Is Not Limited to the Visuospatial Domain: Novel Evidence From the Auditory Domain

OBJECTIVE

Global-local visuospatial processing has been widely investigated in both healthy and clinical populations. Recent studies indicated that individuals with ADHD lack a global processing bias. However, the extant literature regarding global-local processing style focuses solely on the visual modality.

METHODS

ADHD (N = 21) and typically developed (TD) controls (N = 24) underwent an auditory global-local task, in which they had to decide whether the melody is ascending or descending in global or local conditions.

RESULTS

TD controls exhibited a classic global processing bias in the auditory task. The ADHD group exhibited no global processing bias, indicating similar processing for global and local dimensions, implying that individuals with ADHD are distracted by incongruent information in global and local conditions similarly, in both visual and auditory tasks.

CONCLUSION

A lack of global processing bias in ADHD is not limited to the visuospatial modality and likely reflects a broader and more general processing style.

The Tapping-PROMS: A test for the assessment of sensorimotor rhythmic abilities

Sensorimotor synchronization is a longstanding paradigm in the analysis of isochronous beat tapping. Assessing the finger tapping of complex rhythmic patterns is far less explored and considerably more complex to analyze. Hence, whereas several instruments to assess tempo or beat tapping ability exist, there is at present a shortage of paradigms and tools for the assessment of the ability to tap to complex rhythmic patterns. To redress this limitation, we developed a standardized rhythm tapping test comprising test items of different complexity. The items were taken from the rhythm and tempo subtests of the Profile of Music Perception Skills (PROMS), and administered as tapping items to 40 participants (20 women). Overall, results showed satisfactory psychometric properties for internal consistency and test-retest reliability. Convergent, discriminant, and criterion validity correlations fell in line with expectations. Specifically, performance in rhythm tapping was correlated more strongly with performance in rhythm perception than in tempo perception, whereas performance in tempo tapping was more strongly correlated with performance in tempo than rhythm perception. Both tapping tasks were only marginally correlated with non-temporal perception tasks. In combination, the tapping tasks explained variance in external indicators of musical proficiency above and beyond the perceptual PROMS tasks. This tool allows for the assessment of complex rhythmic tapping skills in about 15 min, thus providing a useful addition to existing music aptitude batteries.

Cilia in the Striatum Mediate Timing-Dependent Functions

Almost all brain cells contain cilia, antennae-like microtubule-based organelles. Yet, the significance of cilia, once considered vestigial organelles, in the higher-order brain functions is unknown. Cilia act as a hub that senses and transduces environmental sensory stimuli to generate an appropriate cellular response. Similarly, the striatum, a brain structure enriched in cilia, functions as a hub that receives and integrates various types of environmental information to drive appropriate motor response. To understand cilia's role in the striatum functions, we used loxP/Cre technology to ablate cilia from the dorsal striatum of male mice and monitored the behavioral consequences. Our results revealed an essential role for striatal cilia in the acquisition and brief storage of information, including learning new motor skills, but not in long-term consolidation of information or maintaining habitual/learned motor skills. A fundamental aspect of all disrupted functions was the "time perception/judgment deficit." Furthermore, the observed behavioral deficits form a cluster pertaining to clinical manifestations overlapping across psychiatric disorders that involve the striatum functions and are known to exhibit timing deficits. Thus, striatal cilia may act as a calibrator of the timing functions of the basal ganglia-cortical circuit by maintaining proper timing perception. Our findings suggest that dysfunctional cilia may contribute to the pathophysiology of neuro-psychiatric disorders, as related to deficits in timing perception.

Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders

We provide evidence to support the contention that many aspects of Autistic Spectrum Disorder (ASD) are related to interregional brain functional disconnectivity associated with maturational delays in the development of brain networks. We think a delay in brain maturation in some networks may result in an increase in cortical maturation and development in other networks, leading to a developmental asynchrony and an unevenness of functional skills and symptoms. The paper supports the close relationship between retained primitive reflexes and cognitive and motor function in general and in ASD in particular provided to indicate that the inhibition of RPRs can effect positive change in ASD.

Effects of music on ADHD symptomatology and potential application of music in video games: A systematic review (Preprint)

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) has a considerable impact on an individual's daily life. Some difficulties with timing deficits may be associated with deficiencies in attention, reading, language skills, or executive function. Music therapy, either active (playing an instrument) or passive (listening to music) has demonstrated its efficacy in reducing symptomatology in many disorders. Video games may prove to be a useful assessment and treatment tool in compensating for the difficulties with multimodal treatment in ADHD.

OBJECTIVE

The aim of the study is to (1) analyze the evidence that music is beneficial in reducing the symptomatology of ADHD using systematic review and (2) propose the application of music in video games following music therapy strategies.

METHODS

Searches were conducted in PubMed, Embase, PsycINFO, Cochrane, and gray literature (Google Scholar and WorldCat). We used the following search syntax: ((music[Title/Abstract]) or (music therapy[Title/Abstract])) and (attention deficit disorder[MeSH or thesaurus term]).

RESULTS

Of the 70 records identified, 17 provided findings that music can be beneficial in various domains of ADHD. Active music therapy improves hemispheric synchrony, social skills, aggressivity, and impulsivity. Passive music therapy improves academic skills like arithmetic, drawing, and reading comprehension, as well as attention and disruptive behaviors. The effects depend on the music genre, tempo, or task difficulty. Music in video games was generally found to be beneficial for people with ADHD. Music improves immersion and flow while playing video games. Using rhythm may also improve timing skills and immersion in patients with ADHD. Regarding the proposed application of aspects of music to therapeutic video games for ADHD, some paradigms in timing and music therapy were considered in the proposed design of video games.

CONCLUSIONS

Improving ADHD treatment through the application of music in video games is proposed.

TRIAL REGISTRATION

PROSPERO CRD42021288226; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=288226.

Processing rhythm in speech and music: Shared mechanisms and implications for developmental speech and language disorders

OBJECTIVE

Music and speech are complex signals containing regularities in how they unfold in time. Similarities between music and speech/language in terms of their auditory features, rhythmic structure, and hierarchical structure have led to a large body of literature suggesting connections between the two domains. However, the precise underlying mechanisms behind this connection remain to be elucidated.

METHOD

In this theoretical review article, we synthesize previous research and present a framework of potentially shared neural mechanisms for music and speech rhythm processing. We outline structural similarities of rhythmic signals in music and speech, synthesize prominent music and speech rhythm theories, discuss impaired timing in developmental speech and language disorders, and discuss music rhythm training as an additional, potentially effective therapeutic tool to enhance speech/language processing in these disorders.

RESULTS

We propose the processing rhythm in speech and music (PRISM) framework, which outlines three underlying mechanisms that appear to be shared across music and speech/language processing: Precise auditory processing, synchronization/entrainment of neural oscillations to external stimuli, and sensorimotor coupling. The goal of this framework is to inform directions for future research that integrate cognitive and biological evidence for relationships between rhythm processing in music and speech.

CONCLUSION

The current framework can be used as a basis to investigate potential links between observed timing deficits in developmental disorders, impairments in the proposed mechanisms, and pathology-specific deficits which can be targeted in treatment and training supporting speech therapy outcomes. On these grounds, we propose future research directions and discuss implications of our framework. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Rhythm and timing as vulnerabilities in neurodevelopmental disorders

Millions of children are impacted by neurodevelopmental disorders (NDDs), which unfold early in life, have varying genetic etiologies and can involve a variety of specific or generalized impairments in social, cognitive and motor functioning requiring potentially lifelong specialized supports. While specific disorders vary in their domain of primary deficit (e.g. autism spectrum disorder (social), attention-deficit/hyperactivity disorder (attention), developmental coordination disorder (motor) and developmental language disorder (language)), comorbidities between NDDs are common. Intriguingly, many NDDs are associated with difficulties in skills related to rhythm, timing and synchrony though specific profiles of rhythm/timing impairments vary across disorders. Impairments in rhythm/timing may instantiate vulnerabilities for a variety of NDDs and may contribute to both the primary symptoms of each disorder as well as the high levels of comorbidities across disorders. Drawing upon genetic, neural, behavioural and interpersonal constructs across disorders, we consider how disrupted rhythm and timing skills early in life may contribute to atypical developmental cascades that involve overlapping symptoms within the context of a disorder's primary deficits. Consideration of the developmental context, as well as common and unique aspects of the phenotypes of different NDDs, will inform experimental designs to test this hypothesis including via potential mechanistic intervention approaches. This article is part of the theme issue 'Synchrony and rhythm interaction: from the brain to behavioural ecology'.

Mental health and music engagement: review, framework, and guidelines for future studies

Is engaging with music good for your mental health? This question has long been the topic of empirical clinical and nonclinical investigations, with studies indicating positive associations between music engagement and quality of life, reduced depression or anxiety symptoms, and less frequent substance use. However, many earlier investigations were limited by small populations and methodological limitations, and it has also been suggested that aspects of music engagement may even be associated with worse mental health outcomes. The purpose of this scoping review is first to summarize the existing state of music engagement and mental health studies, identifying their strengths and weaknesses. We focus on broad domains of mental health diagnoses including internalizing psychopathology (e.g., depression and anxiety symptoms and diagnoses), externalizing psychopathology (e.g., substance use), and thought disorders (e.g., schizophrenia). Second, we propose a theoretical model to inform future work that describes the importance of simultaneously considering music-mental health associations at the levels of (1) correlated genetic and/or environmental influences vs. (bi)directional associations, (2) interactions with genetic risk factors, (3) treatment efficacy, and (4) mediation through brain structure and function. Finally, we describe how recent advances in large-scale data collection, including genetic, neuroimaging, and electronic health record studies, allow for a more rigorous examination of these associations that can also elucidate their neurobiological substrates.

Persistent Childhood Primitive Reflex Reduction Effects on Cognitive, Sensorimotor, and Academic Performance in ADHD

A study was performed on 2,175 individuals between the ages of 3.2 and 22.04 years diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and drawn from 89 separate locations across the United States in satellite clinics with common practices and common staff training and equipment. The objective was to determine the efficacy of a hemispheric-based training program to reduce extant retained primitive reflexes (RPRs) and examine the relationship to motor function by metronome-based motor, DL, and cognitive tasks measured by subtests of the Wechsler Wide Range Achievement Test. After a 12-week program, RPR's were significantly reduced, as well as performance on all motor and cognitive measures significantly increased. Listening comprehension demonstrated significant increases between pre- and post-testing of 7% (W = 1213000; df = 2094; p < 0.0001) and mathematical problem solving revealed a significant increase of 5% (W = 1331500; df = 2091; p < 0.0001) associated with a significant reduction in primitive reflexes. The study concluded that the incorporation of relatively simple hemispheric-based programming within the educational system worldwide could relatively inexpensively increase academic, cognitive, and motor performance.

Is atypical rhythm a risk factor for developmental speech and language disorders?

Although a growing literature points to substantial variation in speech/language abilities related to individual differences in musical abilities, mainstream models of communication sciences and disorders have not yet incorporated these individual differences into childhood speech/language development. This article reviews three sources of evidence in a comprehensive body of research aligning with three main themes: (a) associations between musical rhythm and speech/language processing, (b) musical rhythm in children with developmental speech/language disorders and common comorbid attentional and motor disorders, and (c) individual differences in mechanisms underlying rhythm processing in infants and their relationship with later speech/language development. In light of converging evidence on associations between musical rhythm and speech/language processing, we propose the Atypical Rhythm Risk Hypothesis, which posits that individuals with atypical rhythm are at higher risk for developmental speech/language disorders. The hypothesis is framed within the larger epidemiological literature in which recent methodological advances allow for large-scale testing of shared underlying biology across clinically distinct disorders. A series of predictions for future work testing the Atypical Rhythm Risk Hypothesis are outlined. We suggest that if a significant body of evidence is found to support this hypothesis, we can envision new risk factor models that incorporate atypical rhythm to predict the risk of developing speech/language disorders. Given the high prevalence of speech/language disorders in the population and the negative long-term social and economic consequences of gaps in identifying children at-risk, these new lines of research could potentially positively impact access to early identification and treatment. This article is categorized under: Linguistics > Language in Mind and Brain Neuroscience > Development Linguistics > Language Acquisition.

Gait control in children with attention-deficit/hyperactivity disorder

The current profile of gait control in children with ADHD is incomplete and predominately based on children walking forward at a self-selected pace. There are no studies of potential gait deficits in this clinical population when walking in different directions in combination with varying rates of stepping that are freely selected and entrained to an external stimulus. The purpose of the current study was to address this lack of information by assessing gait of children aged 7-17 years with (n = 17) and without (n = 26) ADHD. Participants walked forward and backward along an electronically instrumented carpet at a self-selected stepping rate and in synchrony to a metronome that dictated an increased and decreased stepping rate. Using repeated measures analysis of covariance (ANCOVA) to assess spatiotemporal gait parameters, results showed that children with ADHD exhibited a significantly exaggerated, toes 'turned out,' foot position for all walking conditions compared to typically developing children. When walking backward, children with ADHD produced an increased step width, higher stepping cadence, and increased velocity. Additionally, coefficient of variation ratios indicated that children with ADHD produced greater variability of velocity, cadence, and step time for all walking conditions, and greater variability for stride length when walking at an increased stepping rate. Results were interpreted in terms of clinical significance and practical ramifications that inform rehabilitation specialists in designing therapies that ameliorate the reported gait deficits.