Using virtual reality to define the mechanisms linking symptoms with cognitive deficits in attention deficit hyperactivity disorder

Aman Mangalmurti,Barrington Quarrie,William D Kistler,Philip Shaw,Susan Persky,Wendy Sharp

doi:10.1038/s41598-019-56936-4

Aman Mangalmurti, Barrington Quarrie + Show 4 more

Open Access

https://doi.org/10.1038/s41598-019-56936-4

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Journal: Scientific Reports	Publication Date: Jan 17, 2020
Citations: 19	License type: open-access

Affiliation: National Human Genome Research Institute

Abstract

The mechanisms underpinning attentional deficits are only partially understood. Here we ask if shifts in a child’s field of view (FOV) act as a mediator between symptoms of attention deficit hyperactivity disorder (ADHD) and associated cognitive anomalies, particularly in attentional processes. Real time measurement of shifts in FOV were obtained on 85 children (mean age 9.4 (SD 1.9) years; 45 with DSM 5-defined ADHD) as they completed the continuous performance task in a “virtual classroom”. We extracted measures reflecting focused and selective attention across the task, along with diffusion modelling of latent cognitive processes of information uptake, response conservativeness and non-decision time. Mediation analyses showed that shifts in FOV partially mediated the relationship between hyperactive impulsive symptoms and both poor focused attention and information uptake. Performance accuracy decreased and shifts in FOV increased during the task, but these changes over time did not differ by symptom severity. Employing virtual reality and mediation analysis, we implicate shifts in FOV as a mechanism linking symptoms of ADHD and deficits in focused attention and in the gathering of information to make decisions. The identification of mediating mechanisms might provide new targets for intervention.

Highlights

The mechanisms underpinning attentional deficits are only partially understood
We show that shifts in a child’s field of view (FOV) in part explain the link between hyperactive-impulsive symptoms and deficits in focused attention and information gathering
This link was specific as shifts in FOV did not contribute to deficits pertaining to selective attention nor to other latent cognitive processes, such as a conservative response style

Summary

Introduction

We ask if shifts in a child’s field of view (FOV) act as a mediator between symptoms of attention deficit hyperactivity disorder (ADHD) and associated cognitive anomalies, in attentional processes. Employing virtual reality and mediation analysis, we implicate shifts in FOV as a mechanism linking symptoms of ADHD and deficits in focused attention and in the gathering of information to make decisions. One possible mechanism to link ADHD symptoms with deficits in attention-demanding tasks is rapid shifts in a child’s field of view (FOV) resulting from eye or head movements. A second body of research explores the effect of unique, salient, but otherwise extraneous environmental features, known as a singleton distractors, in capturing attention during attention-demanding tasks[31,32] While such singleton distractors provide an intuitively plausible explanation for deficient attention, there is mixed evidence for a specific effect in individuals with ADHD33–35. We advance the field by examining how another mechanism—shifts in a child’s field of view—might explain how ADHD symptoms are linked to deficits in observed behavior and underlying cognitive processes, using a virtual reality paradigm

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