Dziemian Sabine, Bujia Gaston, Prasse Paul, Barańczuk-Turska Zofia, Jäger Lena A, Kamienkowski Juan E, Langer Nicolas
University of Zurich, Zurich, Switzerland.
Neuroscience Center Zurich (ZNZ), Zurich, Switzerland.
JAACAP Open. 2024 Apr 3;3(2):192-204. doi: 10.1016/j.jaacop.2024.03.001. eCollection 2025 Jun.
Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder. It is associated with deficits in executive functions, especially in visual attention. Deviant visual attention in ADHD is suspected to arise from imbalances between top-down and bottom-up mechanisms. However, it is unclear which of these mechanisms propels the aberrant visual attention.
In 815 medication-naïve children and adolescents (age range 5-21 years), differences in visual attention in participants with ADHD and neurotypical controls were investigated using eye tracking in a naturalistic video viewing task. Two opposing saliency models were used. Finegrained, based on low-level image features, was chosen to estimate bottom-up visually relevant areas. ViNet, a higher-level saliency model based on deep neural networks and trained on the gaze of neurotypical controls, was selected to determine top-down visually relevant regions. Correspondence between gaze and both saliency maps was calculated using normalized scanpath saliency, thus measuring the extent of coherence to bottom-up and top-down relevant contents.
Participants with combined ADHD showed lower mean normalized scanpath saliency for the top-down saliency map, but not the bottom-up one, compared with neurotypical controls. This contrast indicates poorer top-down control as a major contributor to impaired visual attention in combined ADHD. There was no significant effect for the predominantly inattentive ADHD group.
This study demonstrated the use of eye tracking for differentiating between top-down and bottom-up visual attention. It shows that in combined ADHD, a reduction of top-down visual attention is key to an impaired competition between bottom-up and top-down visual attention.
注意力缺陷多动障碍（ADHD）是一种高度流行的神经发育障碍。它与执行功能缺陷有关，尤其是在视觉注意力方面。ADHD中异常的视觉注意力被怀疑是由自上而下和自下而上机制之间的不平衡引起的。然而，尚不清楚这些机制中的哪一种推动了异常的视觉注意力。
在815名未服用药物的儿童和青少年（年龄范围5 - 21岁）中，通过在自然主义视频观看任务中使用眼动追踪，研究了ADHD参与者和神经典型对照组在视觉注意力上的差异。使用了两种相反的显著性模型。基于低级图像特征的细粒度模型被选来估计自下而上的视觉相关区域。ViNet，一种基于深度神经网络并根据神经典型对照组的注视进行训练的高级显著性模型，被选来确定自上而下的视觉相关区域。使用归一化扫描路径显著性计算注视与两个显著性图之间的对应关系，从而测量与自下而上和自上而下相关内容的连贯程度。
与神经典型对照组相比，患有混合型ADHD的参与者在自上而下的显著性图上的平均归一化扫描路径显著性较低，但在自下而上的显著性图上并非如此。这种对比表明，自上而下控制较差是混合型ADHD视觉注意力受损的主要原因。对于以注意力不集中为主的ADHD组没有显著影响。
本研究证明了使用眼动追踪来区分自上而下和自下而上的视觉注意力。研究表明，在混合型ADHD中，自上而下视觉注意力的降低是自下而上和自上而下视觉注意力之间竞争受损的关键。
