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注意缺陷多动障碍患者在自我节奏的自然主义目标导向行为中的注意力波动

Fluctuations of Attention During Self-paced Naturalistic Goal-Directed Behavior in Attention-Deficit/Hyperactivity Disorder.

作者信息

Salmi Juha, Merzon Liya, Eräste Tilda, Seesjärvi Erik, Huhdanpää Hanna, Aronen Eeva T, Mannerkoski Minna, MacInnes W Joseph, Laine Matti

机构信息

Aalto University, Espoo, Finland.

Åbo Akademi University, Turku, Finland.

出版信息

JAACAP Open. 2023 Dec 21;2(3):188-198. doi: 10.1016/j.jaacop.2023.12.002. eCollection 2024 Sep.

Abstract

OBJECTIVE

Temporal fluctuations of attention detected with strictly controlled neuropsychological tests is an important objective behavioral marker for attention-deficit/hyperactivity disorder (ADHD). This study examined whether intraindividual variability in response latencies is also detectable in more realistic open-ended virtual contexts where the participants can freely interact with the surroundings when performing instructed everyday tasks from memory.

METHOD

Three ex-Gaussian parameters, μ, σ, and τ, were derived from response latencies in 2 tasks obtained from 2 datasets comprising 9- to 13-year-old children (72 with ADHD and 71 typically developing controls). In the Executive Performance in Everyday LIving (EPELI) task, participants performed instructed household chores in a virtual apartment. In the other task, a continuous performance test (CPT), was used to examine whether previous findings were replicated in this sample.

RESULTS

Children with ADHD had shorter response latencies than controls in the EPELI task, while group differences in τ reflecting occasional sluggish responses depended on whether the trials were task-relevant (smaller τ in children with ADHD) or task-irrelevant (larger τ in children with ADHD). CPT results replicated previous observations of longer response latencies and larger τ in children with ADHD compared with control children. Intraindividual variability in the naturalistic EPELI task, however, explained more of the symptom variability than the CPT.

CONCLUSION

This study demonstrates that task context and stimulus relevance considerably influence how intraindividual variability in attention is manifested in children with ADHD. Virtual reality tasks provide a promising avenue for ecologically relevant quantification of this common cognitive deficit in neuropsychiatric disorders.

摘要

目的

通过严格控制的神经心理学测试检测到的注意力随时间的波动是注意缺陷多动障碍(ADHD)的一个重要客观行为指标。本研究探讨了在更现实的开放式虚拟环境中,当参与者根据记忆执行日常任务并与周围环境自由互动时,反应潜伏期的个体内变异性是否也能被检测到。

方法

从两个数据集的两项任务的反应潜伏期导出三个前高斯参数μ、σ和τ,这两个数据集包含9至13岁儿童(72名ADHD儿童和71名发育正常的对照儿童)。在日常生活执行表现(EPELI)任务中,参与者在虚拟公寓中执行指定的家务。在另一项任务中,使用连续性能测试(CPT)来检查之前的研究结果是否能在该样本中得到重复。

结果

在EPELI任务中,ADHD儿童的反应潜伏期比对照组短,而反映偶尔反应迟缓的τ的组间差异取决于试验与任务是否相关(ADHD儿童的τ较小)或与任务无关(ADHD儿童的τ较大)。CPT结果重复了之前的观察结果,即与对照儿童相比,ADHD儿童的反应潜伏期更长,τ更大。然而,在自然主义的EPELI任务中的个体内变异性比CPT能解释更多的症状变异性。

结论

本研究表明,任务背景和刺激相关性对ADHD儿童注意力个体内变异性的表现方式有很大影响。虚拟现实任务为在生态相关环境中量化神经精神疾病中这种常见的认知缺陷提供了一条有前景的途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/919f/11562430/0f157d80c1b0/gr1.jpg

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