Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Department of Neurological Diagnosis and Restoration, Osaka University Graduate School of Medicine, CoMIT, Suita, Japan.
J Child Psychol Psychiatry. 2022 Jul;63(7):745-761. doi: 10.1111/jcpp.13514. Epub 2021 Sep 3.
Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) share impairments in top-down and bottom-up modulation of attention. However, it is not yet well understood if co-occurrence of ASD and ADHD reflects a distinct or additive profile of attention deficits. We aimed to characterise alpha oscillatory activity (stimulus-locked alpha desynchronisation and prestimulus alpha) as an index of integration of top-down and bottom-up attentional processes in ASD and ADHD.
Children with ASD, ADHD, comorbid ASD+ADHD, and typically-developing children completed a fixed-choice reaction-time task ('Fast task') while neurophysiological activity was recorded. Outcome measures were derived from source-decomposed neurophysiological data. Main measures of interest were prestimulus alpha power and alpha desynchronisation (difference between poststimulus and prestimulus alpha). Poststimulus activity linked to attention allocation (P1, P3), attentional control (N2), and cognitive control (theta synchronisation, 100-600 ms) was also examined. ANOVA was used to test differences across diagnostics groups on these measures. Spearman's correlations were used to investigate the relationship between attentional control processes (alpha oscillations), central executive functions (theta synchronisation), early visual processing (P1), and behavioural performance.
Children with ADHD (ADHD and ASD+ADHD) showed attenuated alpha desynchronisation, indicating poor integration of top-down and bottom-up attentional processes. Children with ADHD showed reduced N2 and P3 amplitudes, while children with ASD (ASD and ASD+ADHD) showed greater N2 amplitude, indicating atypical attentional control and attention allocation across ASD and ADHD. In the ASD group, prestimulus alpha and theta synchronisation were negatively correlated, and alpha desynchronisation and theta synchronisation were positively correlated, suggesting an atypical association between attentional control processes and executive functions.
ASD and ADHD are associated with disorder-specific impairments, while children with ASD+ADHD overall presented an additive profile with attentional deficits of both disorders. Importantly, these findings may inform the improvement of transdiagnostic procedures and optimisation of personalised intervention approaches.
自闭症谱系障碍 (ASD) 和注意缺陷多动障碍 (ADHD) 在自上而下和自下而上的注意力调节方面都存在障碍。然而，目前还不清楚 ASD 和 ADHD 的同时存在是否反映了注意力缺陷的独特或附加特征。我们旨在以 alpha 振荡活动（刺激锁时 alpha 去同步化和刺激前 alpha）为指标，描述 ASD 和 ADHD 中自上而下和自下而上注意过程的整合。
患有 ASD、ADHD、ASD+ADHD 共病和发育正常的儿童完成了固定选择反应时任务（“Fast 任务”），同时记录神经生理活动。结果测量来自源分解的神经生理数据。主要感兴趣的测量指标是刺激前 alpha 功率和 alpha 去同步化（刺激后和刺激前 alpha 之间的差异）。还检查了与注意力分配（P1、P3）、注意力控制（N2）和认知控制（theta 同步化，100-600ms）相关的刺激后活动。使用 ANOVA 检验这些指标在诊断组之间的差异。使用 Spearman 相关系数来研究注意力控制过程（alpha 振荡）、中央执行功能（theta 同步化）、早期视觉处理（P1）和行为表现之间的关系。
患有 ADHD（ADHD 和 ASD+ADHD）的儿童表现出 alpha 去同步化减弱，表明自上而下和自下而上注意力过程的整合不良。患有 ADHD 的儿童的 N2 和 P3 振幅降低，而患有 ASD（ASD 和 ASD+ADHD）的儿童的 N2 振幅增大，表明 ASD 和 ADHD 中存在异常的注意力控制和注意力分配。在 ASD 组中，刺激前 alpha 和 theta 同步化呈负相关，alpha 去同步化和 theta 同步化呈正相关，表明注意力控制过程和执行功能之间存在异常关联。
ASD 和 ADHD 与特定障碍相关，而 ASD+ADHD 儿童总体上呈现出两种障碍注意力缺陷的附加特征。重要的是，这些发现可能为改善跨诊断程序和优化个性化干预方法提供信息。
