Can auditory warning signals normalize eye movements in children with ADHD?
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ORIGINAL CONTRIBUTION
Can auditory warning signals normalize eye movements in children with ADHD? Johan Lundin Kleberg1,2 · Matilda A. Frick2 · Karin C. Brocki2 Received: 4 August 2019 / Accepted: 27 January 2020 © The Author(s) 2020
Abstract Attenuated baseline arousal has been hypothesized to underlie symptoms of attention deficit/hyperactivity disorder (ADHD). A behavioral signature of reduced baseline arousal is an increased beneficiary effect of warning signals in reaction tasks. This paradoxical effect is believed to be caused by a temporary increase in arousal induced by warning signals. In a preregistered study, we tested the hypothesis that children with high levels of ADHD symptoms would be hyperresponsive to warning signals in a well-established visual attention task (the gap/overlap paradigm). Previous studies using this task have found slower and more variable saccadic reaction times in children with ADHD compared to typically developing children, suggesting that these eye movement metrics are candidate biomarkers. We examined 71 children, of which 1/3 had a diagnosis of ADHD, using both dimensional analyses and group comparisons. Previously reported findings of reduced saccadic latency and increased latency variability were replicated. Importantly, saccadic latency was normalized by auditory warning signals. Analyses of pupil dilation, a physiological index of arousal and locus coeruleus-noradrenergic activity, confirmed that warning signals led to enhanced arousal. Our findings are novel and contribute to our understanding of arousal and attention in ADHD and have implications for treatment and interventions. Keywords ADHD · Pupil dilation · Gap/overlap task · Saccades · Eye tracking
Introduction Attention deficit/hyperactivity disorder (ADHD) is one of the most prevalent childhood onset mental disorders, affecting approximately 5% of children worldwide [1]. Contemporary models define ADHD as consisting of two highly correlated but dissociable symptom dimensions: hyperactivity/ impulsivity and inattention [2]. Symptoms of ADHD are continuous, with the full syndrome constituting the extreme end of phenotypic traits and genetic vulnerability factors Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00787-020-01484-w) contains supplementary material, which is available to authorized users. * Johan Lundin Kleberg [email protected] 1
Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Gävlegatan 22, 113 30 Stockholm, Sweden
Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Box 1225, 751 42 Uppsala, Sweden
2
found in the general population [3, 4]. ADHD is associated with impairments in numerous cognitive functions, including working memory, sustained attention, inhibition, and other executive functions, but the neuropsychological profile of ADHD is heterogeneous [5–7] and a significant proportion of children with ADHD
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