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Korkmaz H, Aydin E, Ocal FCA, Satar B. Evaluation of the Effects of Optokinetic Stimuli and Dual-Task Performance on Vestibulo-Ocular Reflex Function in Children With Attention Deficit and Hyperactivity Disorder. Clin Otolaryngol 2024. [PMID: 39105387 DOI: 10.1111/coa.14201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 05/07/2024] [Accepted: 07/06/2024] [Indexed: 08/07/2024]
Abstract
OBJECTIVES This study investigated the effects of optokinetic stimuli and dual-task performance on vestibulo-ocular reflex (VOR) function. The study primarily focused on understanding the effects of attention deficit and hyperactivity disorder (ADHD) and its subtypes. STUDY DESIGN A case-control study. SETTING Tertiary medical centre. METHODS Thirty-eight children diagnosed with ADHD and 40 typically developing (TD) children aged 8-18 were included in the study. According to their diagnostic reports, children diagnosed with ADHD were also examined in three subtypes: predominantly inattentive (ADHD-PI), predominantly hyperactive-impulsive (ADHD-HI) and the combined type. Functional head impulse test (fHIT) was applied to all participants in three conditions-with no additional stimulus, optokinetic stimulation and dual-task. Correct responses (CR) were determined for each group, and the conditions were compared. For the dual-task test performance, children were given a counting task. RESULTS The findings of the study are significant. The CR values obtained from the fHIT tests applied under three different conditions were lower in the ADHD group compared to the control group. CR values for all fHIT conditions and all semicircular canals were lower in the ADHD-PI subtype and higher in the ADHD-HI subtype compared to other subgroups. CONCLUSION This study has significant practical implications underscoring its relevance. fHIT, when applied with different protocols, can provide valuable information about the vestibular and cognitive states of children with ADHD. These results are particularly significant as the diagnosis of ADHD often relies on subjective interpretations, and fHIT offers a more objective and reliable method of evaluation.
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Affiliation(s)
- Hanifi Korkmaz
- Medical Health Services and Vocational School, Malatya Turgut Ozal University, Battalgazi/Malatya, Turkey
| | - Emine Aydin
- Gulhane Faculty of Medicine, Department of Ear Nose Throat, University of Health Sciences, Ankara, Turkey
| | - Fatma Ceyda Akin Ocal
- Gulhane Faculty of Medicine, Department of Ear Nose Throat, University of Health Sciences, Ankara, Turkey
| | - Bulent Satar
- Gulhane Faculty of Medicine, Department of Ear Nose Throat, University of Health Sciences, Ankara, Turkey
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Calancie OG, Parr AC, Brien DC, Coe BC, Booij L, Khalid-Khan S, Munoz DP. Impairment of Visual Fixation and Preparatory Saccade Control in Borderline Personality Disorder with and without co-morbid Attention-Deficit/ Hyperactivity Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00191-5. [PMID: 39032694 DOI: 10.1016/j.bpsc.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/31/2024] [Accepted: 07/04/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Borderline Personality Disorder (BPD) is associated with heightened impulsivity, evidenced by increased substance abuse, self-harm and suicide attempts. Addressing impulsivity in individuals with BPD is a therapeutic objective; but its underlying neural basis in this clinical population remains unclear, partly due to its frequent co-morbidity with attention-deficit/hyperactivity disorder (ADHD). METHODS We employed a response inhibition paradigm - the interleaved pro-/anti-saccade task (IPAST) - among adolescents diagnosed with BPD with and without comorbid ADHD (N=25 and N=24, respectively) during concomitant video-based eye-tracking. We quantified various eye movement response parameters reflective of impulsive action during the task, including delay to fixation acquisition, fixation breaks, anticipatory saccades, and direction errors with express saccade (Saccade Reaction Time [SRT]: 90-140 ms) and regular saccade latencies (SRT > 140 ms). RESULTS Individuals with BPD exhibited deficient response preparation, exampled by reduced visual fixation on task cues and greater variability of saccade responses (i.e., SRT and peak velocity). The ADHD/BPD group shared these traits, as well as produced an increased frequency of anticipatory responses and direction errors with express saccade latencies and reduced error correction. CONCLUSIONS Saccadic deficits in BPD and ADHD/BPD stem not from an inability to execute anti-saccades, but rather from an inadequate preparation for the upcoming task set. These distinctions may arise due to abnormal signaling in cortical areas like the frontal eye fields, posterior parietal cortex, and anterior cingulate cortex. Understanding these mechanisms could provide insights into targeted interventions focusing on task set preparation to manage response inhibition deficits in BPD and ADHD/BPD.
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Affiliation(s)
- Olivia G Calancie
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada;; School of Medicine, Queen's University, Kingston, ON, Canada;.
| | - Ashley C Parr
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Don C Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Brian C Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Linda Booij
- Department of Psychiatry, McGill University, Montreal, QC, Canada;; Research Centre and Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Sarosh Khalid-Khan
- School of Medicine, Queen's University, Kingston, ON, Canada;; Division of Child and Youth Psychiatry, Department of Psychiatry, School of Medicine, Queen's University, Kingston, ON, Canada
| | - Doug P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
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Teruel MA, Sanchis J, Ruiz-Robledillo N, Albaladejo-Blázquez N, Ferrer-Cascales R, Trujillo J. Measuring attention of ADHD patients by means of a computer game featuring biometrical data gathering. Heliyon 2024; 10:e26555. [PMID: 38434359 PMCID: PMC10907648 DOI: 10.1016/j.heliyon.2024.e26555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
ADHD is a neurodevelopmental disorder diagnosed mainly in children, marked by inattention and hyperactivity-impulsivity. The symptoms are highly variable, such as different ages of onset and potential comorbidities, contributing to frequent misdiagnoses. Professionals note a gap in modern diagnostic tools, making accurate identification challenging. To address this, recent studies recommend gamification for better ADHD diagnosis and treatment, though further research is essential to confirm its efficacy. This work aims to create a serious game, namely "Attention Slackline", to assess attention levels. The game, designed with expert input, requires players to concentrate on a specific point to recognize specific patterns while managing distractions. A controlled experiment tested its precision, and results were compared with established attention tests by a correlation analysis. Statistical analysis confirmed the game's validity, especially in tracking attention through correct responses and errors. Preliminary evidence suggests that "Attention Slackline" may serve as a credible instrument for the assessment of attentional capacities in individuals with ADHD, given that its outcomes have been empirically shown to correlate with those derived from a well-established attention assessment methodology.
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Affiliation(s)
- Miguel A. Teruel
- Lucentia Research Group, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Carretera San Vicente Del Raspeig S/n, 03690, San Vicente Del Raspeig, Alicante, Spain
| | - Javier Sanchis
- Lucentia Research Group, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Carretera San Vicente Del Raspeig S/n, 03690, San Vicente Del Raspeig, Alicante, Spain
- XSB Disseny I Multimedia, S.L., Carrer Del Mercat, 21, 03430, Onil, Alicante, Spain
| | - Nicolás Ruiz-Robledillo
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Carretera San Vicente Del Raspeig S/n, 03690, San Vicente Del Raspeig, Alicante, Spain
| | - Natalia Albaladejo-Blázquez
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Carretera San Vicente Del Raspeig S/n, 03690, San Vicente Del Raspeig, Alicante, Spain
| | - Rosario Ferrer-Cascales
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Carretera San Vicente Del Raspeig S/n, 03690, San Vicente Del Raspeig, Alicante, Spain
| | - Juan Trujillo
- Lucentia Research Group, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Carretera San Vicente Del Raspeig S/n, 03690, San Vicente Del Raspeig, Alicante, Spain
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Motomura Y, Hayashi S, Kurose R, Yoshida H, Okada T, Higuchi S. Effects of others' gaze and facial expression on an observer's microsaccades and their association with ADHD tendencies. J Physiol Anthropol 2023; 42:19. [PMID: 37679805 PMCID: PMC10486107 DOI: 10.1186/s40101-023-00335-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 07/26/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND The aim of this study was to examine the effect of others' gaze on an observer's microsaccades. We also aimed to conduct preliminary investigations on the relationship between the microsaccadic response to a gaze and a gazer's facial expression and attention-deficit/hyperactivity disorder (ADHD) tendencies. METHODS Twenty healthy undergraduate and graduate students performed a peripheral target detection task by using unpredictable gaze cues. During the task, the participants' eye movements, along with changes in pupil size and response times for target detection, were recorded. ADHD tendencies were determined using an ADHD questionnaire. RESULTS We found that consciously perceiving the gaze of another person induced the observer's attention; moreover, microsaccades were biased in the direction opposite to the gaze. Furthermore, these microsaccade biases were differentially modulated, based on the cognitive processing of the facial expressions of the gaze. Exploratory correlation analysis indicated that microsaccade biases toward gazes with fearful expressions may specifically be correlated with participant characteristics, including inattention. CONCLUSIONS Our findings support that microsaccades reflect spatial attention processing and social cognitive processing. Moreover, the exploratory correlation analysis results suggested the potential benefit of using microsaccade bias toward spatial attention to assess pathophysiological responses associated with ADHD tendencies.
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Affiliation(s)
- Yuki Motomura
- Department of Human Life Design, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minamiku, Fukuoka, 815-8540, Japan.
| | - Sayuri Hayashi
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University, 4-9-1 Shiobaru, Minamiku, Fukuoka, 815-8540, Japan
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-0031, Japan
| | - Ryousei Kurose
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University, 4-9-1 Shiobaru, Minamiku, Fukuoka, 815-8540, Japan
| | - Hiroki Yoshida
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University, 4-9-1 Shiobaru, Minamiku, Fukuoka, 815-8540, Japan
| | - Takashi Okada
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-0031, Japan
| | - Shigekazu Higuchi
- Department of Human Life Design, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minamiku, Fukuoka, 815-8540, Japan
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Lee DY, Shin Y, Park RW, Cho SM, Han S, Yoon C, Choo J, Shim JM, Kim K, Jeon SW, Kim SJ. Use of eye tracking to improve the identification of attention-deficit/hyperactivity disorder in children. Sci Rep 2023; 13:14469. [PMID: 37660094 PMCID: PMC10475111 DOI: 10.1038/s41598-023-41654-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood. Although it requires timely detection and intervention, existing continuous performance tests (CPTs) have limited efficacy. Research suggests that eye movement could offer important diagnostic information for ADHD. This study aimed to compare the performance of eye-tracking with that of CPTs, both alone and in combination, and to evaluate the effect of medication on eye movement and CPT outcomes. We recruited participants into an ADHD group and a healthy control group between July 2021 and March 2022 from among children aged 6-10 years (n = 30 per group). The integration of eye-tracking with CPTs produced higher values for the area under the receiver operating characteristic (AUC, 0.889) compared with using CPTs only (AUC, 0.769) for identifying patients with ADHD. The use of eye-tracking alone showed higher performance compare with the use of CPTs alone (AUC of EYE: 0.856, AUC of CPT: 0.769, p = 0.029). Follow-up analysis revealed that most eye-tracking and CPT indicators improved significantly after taking an ADHD medication. The use of eye movement scales could be used to differentiate children with ADHD, with the possibility that integrating eye movement scales and CPTs could improve diagnostic precision.
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Affiliation(s)
- Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Medical Sciences, Graduate School of Ajou University, Suwon, Republic of Korea
| | - Yunmi Shin
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Sun-Mi Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sora Han
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | | | - Jaheui Choo
- Ajou University Hospital, Suwon, Republic of Korea
| | - Joo Min Shim
- Ajou University Hospital, Suwon, Republic of Korea
| | - Kahee Kim
- Department of Medical Sciences, Graduate School of Ajou University, Suwon, Republic of Korea
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sang-Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seong-Ju Kim
- Department of Medical Sciences, Graduate School of Ajou University, Suwon, Republic of Korea.
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 04514, Republic of Korea.
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Caldani S, Humeau E, Delorme R, Bucci MP. Inhibition functions can be improved in children with autism spectrum disorders: An eye-tracking study. Int J Dev Neurosci 2023; 83:431-441. [PMID: 37218472 DOI: 10.1002/jdn.10276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/17/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
Cognitive remediation therapy interventions could improve cognitive functioning in subjects with autism. To investigate the benefit of a short cognitive training rehabilitation in children with autism spectrum disorder (ASD) on pursuit and fixation performances. We recruited two groups (G1 and G2) of 30 children with ASD, sex-, IQ- and age-matched (mean 11.6 ± 0.5 years), and pursuit and fixation eye movements were recorded twice at T1 and T2. Between T1 and T2, a 10-min cognitive training was performed by the G1 group only, whereas the G2 group had a 10-min of rest. For all children with ASD enrolled in the study, there was a positive correlation between restricted and repetitive behaviour scores of both Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) and the number of saccades recorded during the fixation task at T1. At T1, oculomotor performances were similar for both groups of ASD children (G1 and G2). At T2, we observed a significant reduction in the number of saccades made during both pursuit and fixation tasks. Our findings underlined the importance to promote cognitive training rehabilitation for children with ASD, leading to a better performance in inhibitory and attention functioning responsible for pursuit and fixation eye movement's performance.
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Affiliation(s)
- Simona Caldani
- MoDyCo, UMR 7114 CNRS, Paris Nanterre University, Nanterre, France
- EFEE-Center for the Functional Exploration of Balance in Children, Robert Debré Hospital, Paris, France
| | - Elise Humeau
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
- High Functioning Autism Expert Centre, Fundamental Fondation, Paris, France
- Paris University, Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
- High Functioning Autism Expert Centre, Fundamental Fondation, Paris, France
- Paris University, Paris, France
| | - Maria Pia Bucci
- MoDyCo, UMR 7114 CNRS, Paris Nanterre University, Nanterre, France
- EFEE-Center for the Functional Exploration of Balance in Children, Robert Debré Hospital, Paris, France
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Caldani S, Acquaviva E, Moscoso A, Landman B, Michel A, Delorme R, Bucci MP. Motor Capabilities in Children with ADHD Are Improved after Brief Visuopostural Training. Neurol Int 2023; 15:792-803. [PMID: 37489356 PMCID: PMC10366723 DOI: 10.3390/neurolint15030050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/26/2023] Open
Abstract
Children with ADHD show poor motor control. The aim of the present study was to test whether children with ADHD improved their motor performances (oculomotor as well as posture) after a short visuopostural training period. Two groups (G1 trained and G2 non-trained), each comprising 15 children with ADHD matched in IQ (intelligence quotient), sex, and age, participated in the study. Eye movements and postural sway were measured before (T1) and after (T2) 10 min of visuopostural training for the trained group and after 10 min of resting for the non-trained group. Training consisted of a visual search task performed while the child was standing on an unstable platform. At T1, oculomotor and postural abilities were statistically similar for both groups of children with ADHD (trained and non-trained). At T2, significant improvements in both oculomotor and postural capabilities were observed for the trained group but not for the non-trained group. These findings suggest that a short visuopostural training period could help children with ADHD to learn how to focus their visual attention in order to improve motor performance. Visuopostural training could allow a better integration of sensory inputs via central mechanisms, leading to improvement in both oculomotor and postural control. Further studies on a larger number of children with ADHD will be needed to confirm these findings and explore the eventual possible persistence of the training effect.
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Affiliation(s)
- Simona Caldani
- MoDyCo, UMR 7114 CNRS Université Paris Nanterre, 92001 Nanterre, France
- Centre for the Functional Exploration of Balance in Children (EFEE), Robert Debré Hospital, 75019 Paris, France
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Ana Moscoso
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Benjamin Landman
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Alexandre Michel
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
- Paris University, 75005 Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, 75015 Paris, France
| | - Maria Pia Bucci
- MoDyCo, UMR 7114 CNRS Université Paris Nanterre, 92001 Nanterre, France
- Centre for the Functional Exploration of Balance in Children (EFEE), Robert Debré Hospital, 75019 Paris, France
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Lemel R, Shalev L, Nitsan G, Ben-David BM. Listen up! ADHD slows spoken-word processing in adverse listening conditions: Evidence from eye movements. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 133:104401. [PMID: 36577332 DOI: 10.1016/j.ridd.2022.104401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 10/23/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cognitive skills such as sustained attention, inhibition and working memory are essential for speech processing, yet are often impaired in people with ADHD. Offline measures have indicated difficulties in speech recognition on multi-talker babble (MTB) background for young adults with ADHD (yaADHD). However, to-date no study has directly tested online speech processing in adverse conditions for yaADHD. AIMS Gauging the effects of ADHD on segregating the spoken target-word from its sound-sharing competitor, in MTB and working-memory (WM) load. METHODS AND PROCEDURES Twenty-four yaADHD and 22 matched controls that differ in sustained attention (SA) but not in WM were asked to follow spoken instructions presented on MTB to touch a named object, while retaining one (low-load) or four (high-load) digit/s for later recall. Their eye fixations were tracked. OUTCOMES AND RESULTS In the high-load condition, speech processing was less accurate and slowed by 140ms for yaADHD. In the low-load condition, the processing advantage shifted from early perceptual to later cognitive stages. Fixation transitions (hesitations) were inflated for yaADHD. CONCLUSIONS AND IMPLICATIONS ADHD slows speech processing in adverse listening conditions and increases hesitation, as speech unfolds in time. These effects, detected only by online eyetracking, relate to attentional difficulties. We suggest online speech processing as a novel purview on ADHD. WHAT THIS PAPER ADDS?: We suggest speech processing in adverse listening conditions as a novel vantage point on ADHD. Successful speech recognition in noise is essential for performance across daily settings: academic, employment and social interactions. It involves several executive functions, such as inhibition and sustained attention. Impaired performance in these functions is characteristic of ADHD. However, to date there is only scant research on speech processing in ADHD. The current study is the first to investigate online speech processing as the word unfolds in time using eyetracking for young adults with ADHD (yaADHD). This method uncovered slower speech processing in multi-talker babble noise for yaADHD compared to matched controls. The performance of yaADHD indicated increased hesitation between the spoken word and sound-sharing alternatives (e.g., CANdle-CANdy). These delays and hesitations, on the single word level, could accumulate in continuous speech to significantly impair communication in ADHD, with severe implications on their quality of life and academic success. Interestingly, whereas yaADHD and controls were matched on WM standardized tests, WM load appears to affect speech processing for yaADHD more than for controls. This suggests that ADHD may lead to inefficient deployment of WM resources that may not be detected when WM is tested alone. Note that these intricate differences could not be detected using traditional offline accuracy measures, further supporting the use of eyetracking in speech tasks. Finally, communication is vital for active living and wellbeing. We suggest paying attention to speech processing in ADHD in treatment and when considering accessibility and inclusion.
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Affiliation(s)
- Rony Lemel
- Baruch Ivcher School of Psychology, Reichman University (IDC), Herzliya, Israel
| | - Lilach Shalev
- Constantiner School of Education and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Gal Nitsan
- Baruch Ivcher School of Psychology, Reichman University (IDC), Herzliya, Israel; Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Boaz M Ben-David
- Baruch Ivcher School of Psychology, Reichman University (IDC), Herzliya, Israel; Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute, University Health Networks (UHN), ON, Canada.
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Eye movement behavior in a real-world virtual reality task reveals ADHD in children. Sci Rep 2022; 12:20308. [PMID: 36434040 PMCID: PMC9700686 DOI: 10.1038/s41598-022-24552-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/16/2022] [Indexed: 11/26/2022] Open
Abstract
Eye movements and other rich data obtained in virtual reality (VR) environments resembling situations where symptoms are manifested could help in the objective detection of various symptoms in clinical conditions. In the present study, 37 children with attention deficit hyperactivity disorder and 36 typically developing controls (9-13 y.o) played a lifelike prospective memory game using head-mounted display with inbuilt 90 Hz eye tracker. Eye movement patterns had prominent group differences, but they were dispersed across the full performance time rather than associated with specific events or stimulus features. A support vector machine classifier trained on eye movement data showed excellent discrimination ability with 0.92 area under curve, which was significantly higher than for task performance measures or for eye movements obtained in a visual search task. We demonstrated that a naturalistic VR task combined with eye tracking allows accurate prediction of attention deficits, paving the way for precision diagnostics.
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Chamorro Y, Betz LT, Philipsen A, Kambeitz J, Ettinger U. The Eyes Have It: A Meta-analysis of Oculomotor Inhibition in Attention-Deficit/Hyperactivity Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1090-1102. [PMID: 34052459 DOI: 10.1016/j.bpsc.2021.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Diminished inhibitory control is one of the main characteristics of attention-deficit/hyperactivity disorder (ADHD), and impairments in oculomotor inhibition have been proposed as a potential biomarker of the disorder. The present meta-analysis summarizes the effects reported in studies comparing oculomotor inhibition in ADHD patients and healthy control subjects. METHODS Inhibitory outcomes were derived from oculomotor experimental paradigms including the antisaccade (AS), memory-guided saccade, and prolonged fixation tasks. Temporal and spatial measures were also extracted from these tasks and from visually guided saccade tasks as secondary outcomes. Data were available from k = 31 studies (N = 1567 participants). Summary effect sizes were computed using random-effects models and a restricted maximum-likelihood estimator. RESULTS Among inhibitory outcomes, direction errors in AS, after correcting for publication bias, showed a moderate effect and large between-study heterogeneity (k = 18, n = 739, g = 0.57, 95% confidence interval [CI] [0.27, 0.88], I2= 74%); anticipatory saccades in memory-guided saccade showed a large effect and low heterogeneity (k = 11, n = 487; g = 0.86, 95% CI [0.64, 1.08], I2 = 17.7%); and saccades during prolonged fixation evidenced large effect size and heterogeneity (k = 6, n = 325 g = 1.11, 95% CI [0.56, 1.65], I2 = 79.1%) partially related to age. Among secondary outcomes, saccadic reaction time in AS (k = 22, n = 932, g = 0.34, 95% CI [0.06, 0.63], I2 = 53.12%) and coefficient of variability in visually guided saccade (k = 5, n = 282, g = 0.53, 95% CI [0.28, 0.78], I2 = 0.01%) indicated significant effects with small to moderate effects sizes. CONCLUSIONS ADHD groups commit more oculomotor inhibition failures than control groups. The substantial effects support the conclusion that oculomotor disinhibition is a relevant ADHD-related mechanism. Moderate effects observed in saccadic reaction time variability suggest that fluctuant performance in oculomotor tasks is another relevant characteristic of ADHD.
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Affiliation(s)
- Yaira Chamorro
- Institute of Neurosciences, University of Guadalajara, Guadalajara, Mexico.
| | - Linda T Betz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
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Yıldırım Demirdöğen E, Esin İS, Turan B, Dursun OB. Assessing sustained attention of children with ADHD in a class flow video task. Nord J Psychiatry 2022; 76:497-506. [PMID: 35521909 DOI: 10.1080/08039488.2022.2064545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate sustained attention performance of children with ADHD and effect of distractors on sustained attention through an eye-tracking during a class-flow video task. METHOD Data were collected using an eye-tracking during a class-flow task conducted with 60 children (ADHD and control groups). Two areas of interest were determined in the task, these are relevant (teacher and whiteboard) and irrelevant (any regions outside the relevant area) areas. The task also included distractors in relevant and irrelevant areas, comprising a brief conversation and dropping of a pencil, respectively. Proportion of total fixation duration on areas of interest (PFDAOI) was used to assess sustained attention. RESULTS Children with ADHD had lower PFDAOI in the relevant area during the whole class than children in the control group. After the relevant area distractor, PFDAOI increased in relevant area in ADHD group, indicating these children may have better attention after the distractor. However, children with ADHD also showed increased PFDAOI in the irrelevant area following the irrelevant area distractor, indicating that it negatively affected them. There was no significant change in the control group following the distractors. CONCLUSION These findings indicate that children with ADHD have poor sustained attention performance during the whole class. Moreover, distractors in distinct areas could affect children with ADHD differently. Thus, students with ADHD could benefit from increased stimuli in the relevant area and this can be a guide for classroom arrangements to improve the academic functionality of these children.
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Affiliation(s)
- Esen Yıldırım Demirdöğen
- Atatürk University Medicine Faculty, Department of Child and Adolescent Psychiatry, Erzurum, Turkey
| | - İbrahim Selçuk Esin
- Health Science University, Department of Child and Adolescent Psychiatry, Trabzon, Turkey
| | - Bahadır Turan
- Karadeniz Technical University, Department of Child and Adolescent Psychiatry, Trabzon
| | - Onur Burak Dursun
- Health Science University, Department of Child and Adolescent Psychiatry, Trabzon, Turkey
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Krasovsky T, Korytny T, Hamady H, Kizony R. Factors associated with texting and walking performance in children with ADHD: The role of age, environment, and symptom severity. Gait Posture 2022; 98:96-100. [PMID: 36095917 DOI: 10.1016/j.gaitpost.2022.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children with ADHD show deficits in executive function, as well as motor symptoms such as difficulties in gross and fine motor skills and gait stability. Texting while walking is becoming increasingly common and is a significant health risk among people of all ages. RESEARCH QUESTION The objective of this work was to compare texting and walking performance between children with ADHD and controls and between two environments (indoors and outdoors), and evaluate the role of age and symptom severity in dual-task performance. METHODS Nineteen children with ADHD and 30 healthy children walked across an indoors corridor and an outdoors street, with and without texting on a mobile phone. Walking and texting performance were measured using inertial measurement units and a custom-made mobile app. RESULTS No between-group differences were found in texting or walking performance. Walking and texting were similar across environments. In both groups, older children had smaller dual-task performance deficits for both gait and texting speed. Children with ADHD who had more severe symptoms of hyperactivity had larger dual task costs for gait speed outdoors (r = 0.69, p = 0.002), and those with more motor symptoms typed faster under dual-task conditions indoors (r = 0.6, p = 0.007) but were less accurate (r = - 0.60, p = 0.009). SIGNIFICANCE Children with ADHD do not demonstrate deficits in dual-task performance of a texting and walking task indoors or outdoors. The relationship of age, hyperactivity and motor symptoms with texting and walking performance supports a more personalized approach for examination of dual-task performance in children with ADHD.
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Affiliation(s)
- Tal Krasovsky
- Department of Physical Therapy, University of Haifa, Israel; Pediatric Rehabilitation Department, Sheba Medical Center, Israel.
| | - Tamara Korytny
- Department of Physical Therapy, University of Haifa, Israel
| | - Hadeel Hamady
- Department of Occupational Therapy, University of Haifa, Israel
| | - Rachel Kizony
- Department of Occupational Therapy, University of Haifa, Israel; Department of Occupational Therapy, Sheba Medical Center, Israel
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Sadeghi Talarposhti M, Ahmadi-Pajouh MA, Towhidkhah F. A Neuro-Computational Model for Discrete-Continuous Dual-Task Process. Front Comput Neurosci 2022; 16:829807. [PMID: 35422694 PMCID: PMC9003617 DOI: 10.3389/fncom.2022.829807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/28/2022] [Indexed: 12/03/2022] Open
Abstract
Studies on dual-task (DT) procedures in human behavior are important, as they can offer great insight into the cognitive control system. Accordingly, a discrete-continuous auditory-tracking DT experiment was conducted in this study with different difficulty conditions, including a continuous mouse-tracking task concurrent with a discrete auditory task (AT). Behavioral results of 25 participants were investigated via different factors, such as response time (RT), errors, and hesitations (pauses in tracking tasks). In DT, synchronization of different target neuron units was observed in corresponding brain regions; consequently, a computational model of the stimulus process was proposed to investigate the DT interference procedure during the stimulus process. This generally relates to the bottom-up attention system that a neural resource allocates for various ongoing stimuli. We proposed a black-box model based on interactions and mesoscopic behaviors of neural units. Model structure was implemented based on neurological studies and oscillator units to represent neural activities. Each unit represents one stimulus feature of task concept. Comparing the model's output behavior with the experiment results (RT) validates the model. Evaluation of the proposed model and data on RT implies that the stimulus of the AT affects the DT procedure in the model output (84% correlation). However, the continuous task is not significantly changed (26% correlation). The continuous task simulation results were inconsistent with the experiment, suggesting that continuous interference occurs in higher cognitive processing regions and is controlled by the top-down attentional system. However, this is consistent with the psychological research finding of DT interference occurring in response preparation rather than the stimulus process stage. Furthermore, we developed the proposed model by adding qualitative interpretation and saving the model's generality to address various types of discrete continuous DT procedures. The model predicts a justification method for brain rhythm interactions by synchronization, and manipulating parameters would produce different behaviors. The decrement of coupling parameter and strength factor would predict a similar pattern as in Parkinson's disease and ADHD disorder, respectively. Also, by increasing the similarity factor among the features, the model's result shows automatic task performance in each task.
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Priscilla Martinez-Cedillo A, Dent K, Foulsham T. Do cognitive load and ADHD traits affect the tendency to prioritise social information in scenes? Q J Exp Psychol (Hove) 2022; 75:1904-1918. [PMID: 34844477 PMCID: PMC9424720 DOI: 10.1177/17470218211066475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
We report two experiments investigating the effect of working memory (WM)
load on selective attention. Experiment 1 was a modified version of
Lavie et al. and confirmed that increasing memory load disrupted
performance in the classic flanker task. Experiment 2 used the same
manipulation of WM load to probe attention during the viewing of
complex scenes while also investigating individual differences in
attention deficit hyperactivity disorder (ADHD) traits. In the
image-viewing task, we measured the degree to which fixations targeted
each of two crucial objects: (1) a social object (a person in the
scene) and (2) a non-social object of higher or lower physical
salience. We compared the extent to which increasing WM load would
change the pattern of viewing of the physically salient and socially
salient objects. If attending to the social item requires greater
default voluntary top-down resources, then the viewing of social
objects should show stronger modulation by WM load compared with
viewing of physically salient objects. The results showed that the
social object was fixated to a greater degree than the other object
(regardless of physical salience). Increased salience drew fixations
away from the background leading to slightly increased fixations on
the non-social object, without changing fixations on the social
object. Increased levels of ADHD-like traits were associated with
fewer fixations on the social object, but only in the high-salient,
low-load condition. Importantly, WM load did not affect the number of
fixations on the social object. Such findings suggest rather
surprisingly that attending to a social area in complex stimuli is not
dependent on the availability of voluntary top-down resources.
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Affiliation(s)
| | - Kevin Dent
- Department of Psychology, University of Essex, Colchester, UK
| | - Tom Foulsham
- Department of Psychology, University of Essex, Colchester, UK
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Lin HY, Chang WD, Hsieh HC, Yu WH, Lee P. Relationship between intraindividual auditory and visual attention in children with ADHD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 108:103808. [PMID: 33242747 DOI: 10.1016/j.ridd.2020.103808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 10/13/2020] [Accepted: 10/26/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND AIM Most previous attention-deficit/hyperactivity disorder (ADHD) studies have used only a single sensory modality (usually vision) to investigate attentional problems, although patients with ADHD might display deficits of auditory attention similar to their visual attention. This study explored intraindividual auditory and visual attention in children with and without ADHD to examine the relationship between these two dimensions of attention. METHODS Attentional performances of 140 children (70 children with ADHD and 70 typically developing peers) were measured through the Test of Variables of Attention (TOVA) in the present study. RESULTS For both groups, most attentional indices showed significant differences between the two modalities (d ranging from 0.32 to 0.72). The correlation coefficients of most of the attentional variables in children with ADHD were lower than their typically developing peers. All attentional indices of children with ADHD (ranging from 12.8%-55.7%) were much higher than those of their typically developing peers (ranging from 1.4%-8.6%). CONCLUSION These results not only indicate that typically developing children display more consistent attentional performance, but also support the view that children with ADHD may show attention deficiency in one modality but not necessarily in the other.
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Affiliation(s)
- Hung-Yu Lin
- Department of Occupational Therapy at Asia University, Taichung, Taiwan.
| | - Wen-Dien Chang
- Department of Sport Performance at National Taiwan University of Sport, Taichung, Taiwan
| | - Hsieh-Chun Hsieh
- Department of Special Education at National Tsing Hua University, Hsinchu, Taiwan
| | - Wan-Hui Yu
- Department of Occupational Therapy at Asia University, Taichung, Taiwan
| | - Posen Lee
- Department of Occupational Therapy at I-Shou University, Kaohsiung, Taiwan
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Magliacano A, Fiorenza S, Estraneo A, Trojano L. Eye blink rate increases as a function of cognitive load during an auditory oddball paradigm. Neurosci Lett 2020; 736:135293. [PMID: 32771601 DOI: 10.1016/j.neulet.2020.135293] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/08/2020] [Accepted: 08/03/2020] [Indexed: 01/21/2023]
Abstract
Previous evidence suggests that changes in spontaneous eye blink rate (EBR) in human adults might reflect the amount of attentional demand (i.e. cognitive load) during cognitive tasks. However, the actual direction of this relation is uncertain, since most studies investigated the role of cognitive load on EBR by employing visual tasks only. Here we aimed at elucidating the relationship between EBR and cognitive load in non-visual tasks. Sixteen healthy participants performed two auditory oddball tasks, i.e. passive listening to auditory tones versus active counting of target tones; each oddball task was immediately followed by a rest phase. Throughout the oddball tasks we assessed EBR and recorded the P300 on ERPs as an electrophysiological measure of attention. The results showed that participants' EBR increased during the active task compared to the respective rest phase. Amplitude and latency of the P300 too differed between passive and active tasks, but changes in EBR and P300 features were not correlated with each other. Our findings demonstrated that an increase in cognitive load is associated with an increase in EBR in cognitive tasks not involving visual attention. These findings are consistent with previous evidence suggesting shared neurobiological bases between attention and EBR.
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Affiliation(s)
- Alfonso Magliacano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
| | - Salvatore Fiorenza
- Istituti Clinici Scientifici Maugeri IRCCS, SB S.p.A., Laboratorio di Valutazione Multimodale dei Disordini della Coscienza, Telese Terme BN, Italy
| | | | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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Levantini V, Muratori P, Inguaggiato E, Masi G, Milone A, Valente E, Tonacci A, Billeci L. EYES Are The Window to the Mind: Eye-Tracking Technology as a Novel Approach to Study Clinical Characteristics of ADHD. Psychiatry Res 2020; 290:113135. [PMID: 32505031 DOI: 10.1016/j.psychres.2020.113135] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/23/2020] [Accepted: 05/23/2020] [Indexed: 11/19/2022]
Abstract
In recent years, the study of eye movements has increasingly become a window into neurological function and processes. This paper reports data about applications of eye-tracking technology in the field of neurodevelopmental disorders, especially in studying the clinical characteristics of ADHD. These studies indicated that eye-tracking approach represents a non-invasive methodology to test specific domains, such as attention networks and inhibition control, in an objectively and reliable way in youths. Although the studies results are still not conclusive, eye-tracking represents a potential valid support for clinicians in identifying specific biomarkers to orient ADHD diagnosis and the best intervention strategies.
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Affiliation(s)
- Valentina Levantini
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Pietro Muratori
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy.
| | - Emanuela Inguaggiato
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Gabriele Masi
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Annarita Milone
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Elena Valente
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Alessandro Tonacci
- Institute of Clinical Physiology, National Research Council of Italy (CNR), Pisa, Italy
| | - Lucia Billeci
- Institute of Clinical Physiology, National Research Council of Italy (CNR), Pisa, Italy
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