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注意力缺陷多动障碍(ADHD)患者在预期视觉刺激时无法抑制眨眼和微扫视,但药物治疗后可恢复。

ADHD subjects fail to suppress eye blinks and microsaccades while anticipating visual stimuli but recover with medication.

作者信息

Fried Moshe, Tsitsiashvili Eteri, Bonneh Yoram S, Sterkin Anna, Wygnanski-Jaffe Tamara, Epstein Tamir, Polat Uri

机构信息

Goldschleger Eye Research Institute, Tel Aviv University, Tel Hashomer, Israel.

Department of Human Biology, University of Haifa, Haifa, Israel.

出版信息

Vision Res. 2014 Aug;101:62-72. doi: 10.1016/j.visres.2014.05.004. Epub 2014 May 23.

Abstract

Oculomotor behavior and parameters are known to be affected by the allocation of attention and could potentially be used to investigate attention disorders. We explored the oculomotor markers of Attention-deficit/hyperactivity disorder (ADHD) that are involuntary and quantitative and that could be used to reveal the core-affected mechanisms, as well as be used for differential diagnosis. We recorded eye movements in a group of 22 ADHD-diagnosed patients with and without medication (methylphenidate) and in 22 control observers while performing the test of variables of attention (t.o.v.a.). We found that the average microsaccade and blink rates were higher in the ADHD group, especially in the time interval around stimulus onset. These rates increased monotonically over session time for both groups, but with significantly faster increments in the unmedicated ADHD group. With medication, the level and time course of the microsaccade rate were fully normalized to the control level, regardless of the time interval within trials. In contrast, the pupil diameter decreased over time within sessions and significantly increased above the control level with medication. We interpreted the suppression of microsaccades and eye blinks around the stimulus onset as reflecting a temporal anticipation mechanism for the transient allocation of attention, and their overall rates as inversely reflecting the level of arousal. We suggest that ADHD subjects fail to maintain sufficient levels of arousal during a simple and prolonged task, which limits their ability to dynamically allocate attention while anticipating visual stimuli. This impairment normalizes with medication and its oculomotor quantification could potentially be used for differential diagnosis.

摘要

已知眼球运动行为和参数会受到注意力分配的影响,并且有可能用于研究注意力障碍。我们探索了注意力缺陷多动障碍(ADHD)的眼球运动标志物,这些标志物是无意识且定量的,可用于揭示核心受影响机制,也可用于鉴别诊断。我们记录了22名已确诊患有ADHD的患者(包括用药和未用药(哌甲酯))以及22名对照观察者在进行注意力变量测试(TOVA)时的眼动情况。我们发现,ADHD组的平均微扫视和眨眼率更高,尤其是在刺激开始前后的时间段。两组的这些比率在测试过程中均单调增加,但未用药的ADHD组增加得明显更快。用药后,微扫视率的水平和时间进程完全恢复到对照水平,无论试验中的时间间隔如何。相比之下,瞳孔直径在测试过程中随时间减小,用药后显著增加至高于对照水平。我们将刺激开始前后微扫视和眨眼的抑制解释为反映了注意力瞬时分配的时间预期机制,而它们的总体比率则反向反映了唤醒水平。我们认为,ADHD患者在简单且持续的任务中无法维持足够的唤醒水平,这限制了他们在预期视觉刺激时动态分配注意力的能力。这种损伤在用药后恢复正常,其眼球运动量化可能潜在地用于鉴别诊断。

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