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Transcranial Doppler sonography reveals sustained attention deficits in young adults diagnosed with ADHD

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Abstract

The National Institute of Mental Health has recently launched the Research Domain Criteria framework that seeks to inform clinical classification schemes by elevating the status of neuroscience research in the diagnosis of mental disorders. The current research seeks to contribute to that initiative by using a neurophysiological measure, transcranial Doppler sonography that has been shown to be sensitive to decrements in sustained attention and may provide an additional biomarker of executive dysfunction in ADHD. Twenty-seven participants performed a 12-min vigilance task while cerebral blood flow velocity (CBFV) was recorded. Thirteen participants were included in an ADHD condition if they had been formally diagnosed with ADHD. The remaining 14 participants who had never been formally diagnosed with ADHD were included in the control condition. Participants that had been diagnosed with ADHD demonstrated a steeper decrement in performance accuracy, a steeper decrement in perceptual sensitivity, and employed a more liberal response bias over time as compared to the control participants. Critically, the decrement in CBFV was steeper for participants previously diagnosed with ADHD than those who were not. Moreover, CBFV was found to better predict decreases in sensitivity and hit rate, as well as increases in liberal responding above and beyond self-reported ADHD symptoms. Results suggest that CBFV can be used to index failures of executive control in ADHD and can predict response strategy, and that the measure may provide an additional index of the sustained attention deficits associated with ADHD compared to traditional diagnostic methods.

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References

  • Aaslid R (1986) Transcranial Doppler examination techniques. In: Aaslid R (ed) Transcranial Doppler sonography. Springer, Vienna, pp 39–59

    Chapter  Google Scholar 

  • Aaslid R (1987) Visually evoked dynamic blood flow response of the human cerebral circulation. Stroke 18:771–775

    Article  CAS  PubMed  Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. Author Arlington, Arlington

    Book  Google Scholar 

  • Baayen RH, Davidson DJ, Bates DM (2008) Mixed-effects modeling with crossed random effects for subjects and items. J Mem Lang 59:390–412

    Article  Google Scholar 

  • Babikan VL, Wechsler LR (1999) Transcranial Doppler ultrasonography, 2nd edn. Butterworth-Heinemann, Boston

    Google Scholar 

  • Barkley RA (2014) Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. Guilford Publications, New York

    Google Scholar 

  • Bates DM, Maechler M, Bolker B (2012) lme4: Linear mixed-effects models using S4 classes. R package version 0.999999-0

  • Becker A, Mandell AR, Tangney JP, Chrosniak LD, Shaw TH (2015) The effects of self-control on cognitive resource allocation during sustained attention: a transcranial Doppler investigation. Exp Brain Res 233:2215–2223

    Article  PubMed  Google Scholar 

  • Boonstra AM, Oosterlaan J, Sergeant JA, Buitelaar JK (2005) Executive functioning in adult ADHD: a meta-analytic review. Psychol Med 35:1097–1108

    Article  PubMed  Google Scholar 

  • Caplan LR, Brass LM, DeWitt LD, Adams RJ, Gomex C, Otis S, Weschler LR, von Reutern GM (1990) Transcranial Doppler ultrasound: present status. Neurology 40:696–700

    Article  CAS  PubMed  Google Scholar 

  • Cole MW, Repovš G, Anticevic A (2014) The frontoparietal control system: a central role in mental health. Neuroscientist 20:652–664

    Article  PubMed  PubMed Central  Google Scholar 

  • Conners CK (1994) The Conners continuous performance test. Multi-Health Systems Inc, Toronto

    Google Scholar 

  • Cortese S, Kelly C, Chabernaud C, Proal E, Di Martino A, Milham MP, Castellanos FX (2012) Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies. Am J Psychiatry 169:1038–1055

    Article  PubMed  Google Scholar 

  • Cuthbert BN (2014) The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry 13:28–35

    Article  PubMed  PubMed Central  Google Scholar 

  • Cuthbert BN, Insel TR (2013) Toward the future of psychiatric diagnosis: the seven pillars of RDoC. BMC Med 11:126

    Article  PubMed  PubMed Central  Google Scholar 

  • Duschek S, Schandry R (2003) Functional transcranial Doppler sonography as a tool in psychophysiological research. Psychophysiology 40:436–454

    Article  Google Scholar 

  • Epstein JN, Erkanli A, Conners CK, Klaric J, Costello JE, Angold A (2003) Relations between continuous performance test performance measures and ADHD behaviors. J Abnorm Child Psychol 3:543–554

    Article  Google Scholar 

  • Fayyad et al (2007) Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry 190:402–409

    Article  CAS  PubMed  Google Scholar 

  • Frick PJ, Nigg JT (2012) Current issues in the diagnosis of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Ann Rev Clin Psychol 8:77–107

    Article  Google Scholar 

  • Galinsky TL, Roger RR, Warm JS, Dember WN (1993) Psychophysical determinants of stress in sustained attention. Hum Factors 35:603–614

    Article  CAS  PubMed  Google Scholar 

  • Harwood AE, Greenwood PM, Shaw TH (2017) Transcranial doppler sonography reveals reductions in hemispheric asymmetry in healthy older adults during vigilance. Front Aging Neurosci 9:21

    Article  PubMed  PubMed Central  Google Scholar 

  • Helton WS (2009) Impulsive responding and the sustained attention to response task. J Clin Exp Neuropsychol 31:39–47

    Article  PubMed  Google Scholar 

  • Helton WS, Kern RP, Walker DR (2009) Conscious thought and the sustained attention to response task. Conscious Cogn 18:600–607

    Article  PubMed  Google Scholar 

  • Hervey AS, Epstein JN, Curry JF (2004) Neuropsychology of adults with attention-deficit/hyperactivity disorder: a meta-analytic review. Neuropsychology 18:485

    Article  PubMed  Google Scholar 

  • Hitchcock EM, Warm JS, Matthews G, Dember WN, Shear PK, Tripp LD, Parasuraman R (2003) Automation cueing modulates cerebral blood flow and vigilance in a simulated air traffic control task. Theor Issues Ergon Sci 4:89–112

    Article  Google Scholar 

  • Hockey GRJ (1997) Compensatory control in the regulation of human performance under stress and high workload: a cognitive-energetical framework. Biol Psychol 45:73–93

    Article  CAS  PubMed  Google Scholar 

  • Insel T et al (2010) Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 167:748–751

    Article  PubMed  Google Scholar 

  • Johnson A, Proctor RW (2004) Attention: theory and practice. Sage, Thousand Oaks

    Book  Google Scholar 

  • Kapur S, Phillips AG, Insel TR (2012) Why has it taken so long for biological psychiatry to develop clinical tests and what to do about it? Mol Psychiatry 17:1174

    Article  CAS  PubMed  Google Scholar 

  • Kessler RC et al (2010) Structure and diagnosis of adult attention-deficit/hyperactivity disorder: analysis of expanded symptom criteria from the Adult ADHD Clinical Diagnostic Scale. Arch Gen Psychiatry 67:1168–1178

    Article  PubMed  PubMed Central  Google Scholar 

  • Langner R, Eickhoff SB, Steinborn MB (2011) Mental fatigue modulates dynamic adaptation to perceptual demand in speeded detection. PLoS One 6:1–10

    Article  CAS  Google Scholar 

  • Lim J, Wu W, Wang J, Detre JA, Dinges DF, Rau H (2010) Imaging brain fatigue from sustained mental workload: An ASL perfusion study of the time-on-task effect. NeuroImage49:3426–3435

    Google Scholar 

  • Losier BJ, McGrath PJ, Klein RM (1996) Error patterns on the continuous performance test in non-medicated and medicated samples of children with and without ADHD: a meta-analytic review. J Child Psychol Psychiatry 37:971–987

    Article  CAS  PubMed  Google Scholar 

  • Macmillan N, Creelman C (2004) Detection theory. Psychology Press, New York

    Book  Google Scholar 

  • Mandell A, Becker A, VanAndel A, Nelson A, Shaw TH (2015) The effect of neuroticism on vigilance performance: a transcranial Doppler investigation. Conscious Cogn 36:19–26

    Article  PubMed  Google Scholar 

  • Matthews G, Joyner L, Gilliland K, Campbell SE, Huggins J, Falconer S (1999) Validation of a comprehensive stress state questionnaire: towards a state “big three”? In: Mervielde I, Deary IJ, De Fruyt F, Ostendorf F (eds) Personality psychology in Europe, vol 7. Tilburg University Press, Tilburg, pp 335–350

    Google Scholar 

  • Matthews G, Campbell SE, Falconer S, Joyner L, Huggins J, Gilliland K, Grier R, Warm JS (2002) Fundamental dimensions of subjective state in performance settings: task engagement, distress and worry. Emotion 2:315–340

    Article  PubMed  Google Scholar 

  • Matthews G, Warm JS, Reinerman-Jones LE, Langheim LK, Guznov S, Shaw TH, Finomore VS (2011) The functional fidelity of individual differences research: the case for context-matching. Theor Issues Ergon Sci 12:435–450

    Article  Google Scholar 

  • Matthews G, Warm JS, Shaw TH, Finomore VS (2014) Predicting battlefield vigilance: a multivariate approach to assessment of attentional resources. Ergonomics 57:856–875

    Article  PubMed  Google Scholar 

  • McGee RA, Clark SE, Symons DK (2000) Does the conners’ continuous performance test aid in ADHD diagnosis? J Abnorm Child Psychol 28:415–424

    Article  CAS  PubMed  Google Scholar 

  • McGrath et al (2013) Toward a neuroimaging treatment selection biomarker for major depressive disorder. JAMA Psychiatry 70:821–829

    Article  PubMed  PubMed Central  Google Scholar 

  • Norman DA, Bobrow DG (1975) On data-limited and resource limited processes. Cogn Psychol 7:44–64

    Article  Google Scholar 

  • Parasuraman R (1979) Memory load and event rate control sensitivity decrements in sustained attention. Science 205:924–927

    Article  CAS  PubMed  Google Scholar 

  • Parasuraman R (1984) Sustained attention in detection and discrimination. In: Parasuraman R, Davis DR (eds) Varieties of attention. Academic Press, New York, pp 243–271

    Google Scholar 

  • Parasuraman R (2009) Assaying individual differences in cognition with molecular genetics: theory and application. Theor Issues Ergon Sci 10:399–416

    Article  Google Scholar 

  • Parasuraman R, Rizzo M (2007) Neuroergonomics: the brain at work. Oxford University Press, New York

    Google Scholar 

  • Parasuraman R, Warm JS, Dember WN (1987) Vigilance: taxonomy and utility. Ergonomics and human factors. Springer, New York, pp 11–32

    Book  Google Scholar 

  • Parasuraman R, Warm JS, See JE (1998) The attentive brain. MIT Press, Cambridge, pp 221–256

    Google Scholar 

  • Pinheiro JC, Bates DM (2000) Mixed-effects models in S and S-PLUS. Springer Science and Business Media, New York

    Book  Google Scholar 

  • Posner MI, Raichle M (1993) Images of mind. McGraw-Hill, New York

    Google Scholar 

  • Proctor RW, Vu KPL (2012) Human information processing. Encyclopedia of the science of learning. Springer, New York, pp 1458–1460

    Google Scholar 

  • R Core Team (2013) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. http://www.R-project.org/. Accessed 2016

  • Raz A, Lieber B, Soliman F, Buhle J, Posner J, Peterson BS, Posner MI (2005) Ecological nuances in functional magnetic resonance imaging (fMRI): psychological stressors, posture, and hydrostatics. Neuroimage 25:1–7

    Article  PubMed  Google Scholar 

  • Riccio CA, Reynolds CR, Lowe PA (2001) Clinical applications of continuous performance tests: measuring attention and impulsive responding in children and adults. Wiley, New York

    Google Scholar 

  • Roth RM, Saykin AJ (2004) Executive dysfunction in attention-deficit/hyperactivity disorder: cognitive and neuroimaging findings. Psychiatr Clin N Am 27:83–96

    Article  Google Scholar 

  • Satterthwaite FE (1946) An approximate distribution of estimates of variance components. Biom Bull 2(6):110–114

    Article  CAS  Google Scholar 

  • Schmidt et al (1999) Determination of cognitive hemispheric lateralization by ‘‘functional’’ transcranial Doppler cross-validated by functional MRI. Stroke 30:939–945

    Article  CAS  PubMed  Google Scholar 

  • Schnittger C, Johannes S, Arnavaz A, Münte TF (1997) Relation of cerebral blood flow velocity and level of vigilance in humans. NeuroReport 8:1637–1639

    Article  Google Scholar 

  • Scolari M, Seidl-Rathkopf KN, Kastner S (2015) Functions of the human frontoparietal attention network: evidence from neuroimaging. Curr Opin Behav Sci 1:32–39

    Article  PubMed  Google Scholar 

  • Shaw TH, Warm JS, Finomore V, Tripp L, Matthews G, Weiler E, Parasuraman R (2009) Effects of sensory modality on cerebral blood flow velocity during vigilance. Neurosci Lett 461:207–211

    Article  CAS  PubMed  Google Scholar 

  • Shaw T, Emfield A, Garcia A, de Visser E, Miller C, Parasuraman R, Fern L (2010a) Evaluating the benefits and potential costs of automation delegation for supervisory control of multiple UAVs. In: Proc of the hum fac and erg soc. Los Angeles, CA: SAGE Publications

  • Shaw TH, Matthews G, Warm JS, Finomore VS, Silverman L, Costa PT (2010b) Individual differences in vigilance: personality, ability and states of stress. J Res Pers 44:297–308

    Article  Google Scholar 

  • Shaw TH, Finomore VS, Warm JS, Matthews G (2012) Effects of regular or irregular event schedules on cerebral hemovelocity during a sustained attention task. J Clin Exp Neuropsychol 34:57–66

    Article  PubMed  Google Scholar 

  • Shaw TH, Satterfield K, Ramirez R, Finomore V (2013) Using cerebral hemovelocity to measure workload during a spatialized auditory vigilance task in novice and experienced observers. Ergonomics 56:1251–1263

    Article  PubMed  Google Scholar 

  • Shaw TH, Nguyen C, Satterfield K, Ramirez R, McKnight PE (2016) Cerebral hemovelocity reveals differential resource allocation strategies for extraverts and introverts during vigilance. Exp Brain Res 234:577–585

    Article  PubMed  Google Scholar 

  • Shingledecker S, Weldon DE, Behymer K, Simpkins B, Lerner E, Warm J, Matthews G, Finomore V, Shaw T, Murphy JS (2009) Measuring vigilance abilities to enhance combat identification performance. In: Andrews DH, Herz RP, Wolf MB (eds) Human factors in combat identification performanc. Ashgate Publishing, Aldershot, UK, pp 47–65

    Google Scholar 

  • Stroobant N, Vingerhoets G (2000) Transcranial Doppler ultrasonography monitoring of cerebral hemodynamics during performance of cognitive tasks: a review. Neuropsychol Rev 10:213–231

    Article  CAS  PubMed  Google Scholar 

  • Temple JG, Warm JS, Dember WN, Jones KS, LaGrange CM, Matthews G (2000) The effects of signal salience and caffeine on performance, workload, and stress in an abbreviated vigilance task. Hum Factors 42:183–194

    Article  CAS  PubMed  Google Scholar 

  • Toplak ME, PitchA FloraDB, Iwenofu L, Ghelani K, Jain U, Tannock R (2009) The unity and diversity of inattention and hyperactivity/impulsivity in ADHD: evidence for a general factor with separable dimensions. J Abnorm Child Psychol 37:1137–1150

    Article  PubMed  Google Scholar 

  • Tulving E, Kapur S, Craik FI, Moscovitch M, Houle S (1994) Hemispheric encoding/retrieval asymmetry in episodic memory: positron emission tomography findings. Proc Natl Acad Sci 91:2016–2020

    Article  CAS  PubMed  Google Scholar 

  • Warm JS, Parasuraman R, Matthews G (2008) Vigilance requires hard mental work and is stressful. Hum Factors 50:433–441

    Article  PubMed  Google Scholar 

  • Warm JS, Matthews G, Parasuraman R (2009) Cerebral hemodynamics and vigilance performance. Milit Psychol 21(Suppl. 1):S75–S100

    Google Scholar 

  • Wiggins MW (2011) Vigilance decrement during a simulated general aviation flight. Appl Cogn Psychol 25:229–235

    Article  Google Scholar 

  • Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF (2005) Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 57:1336–1346

    Article  PubMed  Google Scholar 

  • Woods SP, Lovejoy DW, Ball JD (2002) Neuropsychological characteristics of adults with ADHD: a comprehensive review of initial studies. Clin Neuropsychol 16:12–34

    Article  PubMed  Google Scholar 

  • Young S (2004) The YAQ-S and YAQ-I: the development of self and informant questionnaires reporting on current adult ADHD symptomatology, comorbid and associated problems. Pers Individ Differ 36:1211–1223

    Article  Google Scholar 

  • Young S, Gudjonsson GH (2005) Neuropsychological correlates of the YAQ-S and YAQ-I self-and informant-reported ADHD symptomatology, emotional and social problems and delinquent behaviour. Br J Clin Psychol 44:47–57

    Article  PubMed  Google Scholar 

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  1. Department of Psychology, George Mason University, 4400 University Dr MS3F5, Fairfax, VA, 22030-4444, USA

    Tyler H. Shaw, Timothy W. Curby, Kelly Satterfield, Samuel S. Monfort & Raul Ramirez

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  1. Tyler H. Shaw
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Shaw, T.H., Curby, T.W., Satterfield, K. et al. Transcranial Doppler sonography reveals sustained attention deficits in young adults diagnosed with ADHD. Exp Brain Res 237, 511–520 (2019). https://doi.org/10.1007/s00221-018-5432-y

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