Interstimulus jitter facilitates response control in children with ADHD

Abstract Interstimulus “jitter” involves randomization of intervals between successive stimulus events, and can facilitate performance on go/no-go tests among healthy adults, though its effect in clinical populations is unclear. Children with Attention-deficit/Hyperactivity Disorder (ADHD) commonly exhibit deficient response control, leading to increased intra-subject variability (ISV), which has been linked to anomalous functioning within frontal circuits, as well as their interaction with posterior “default mode” regions. We examined effects of interstimulus jitter on response variability in 39 children, ages 9–14 years (25 ADHD, 14 controls). Participants completed 2 computerized go/no-go tests: one with fixed interstimulus interval (ISI) and one with jittered ISI. Repeated measures analysis of variance (ANOVA) revealed a significant group–by test interaction, such that introduction of jitter produced a significant decrease in ISV among children with ADHD, but not among controls. Whereas children with ADHD were significantly more variable than controls on the go/no-go test with fixed ISI, their performance with jittered ISI was equivalent to that of controls. Jittering stimulus presentation provides a nonpharmacologic mechanism for improving response control in ADHD. This bottom-up approach may be mediated by increases in vigilance through noradrenergic circuits that facilitate maintenance of frontal circuits critical to response control. (JINS, 2010, 16, 388–393.)

[1]  E. L. Harris,et al.  Executive function in children with Tourette Syndrome and/or Attention Deficit Hyperactivity Disorder , 1995, Journal of the International Neuropsychological Society.

[2]  M. Denckla,et al.  Biological Correlates of Learning and Attention: What Is Relevant to Learning Disability and Attention‐Deficit Hyperactivity Disorder? , 1996, Journal of developmental and behavioral pediatrics : JDBP.

[3]  C. Karatekin A test of the integrity of the components of Baddeley's model of working memory in attention-deficit/hyperactivity disorder (ADHD). , 2004, Journal of child psychology and psychiatry, and allied disciplines.

[4]  E. Taylor,et al.  Performance of Children with Attention Deficit Hyperactivity Disorder (ADHD) on a Test Battery of Impulsiveness , 2007, Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence.

[5]  Kimberly Hoagwood,et al.  Assessing medication effects in the MTA study using neuropsychological outcomes. , 2006, Journal of child psychology and psychiatry, and allied disciplines.

[6]  Stewart H. Mostofsky,et al.  Evidence that response inhibition is a primary deficit in ADHD , 2007, Journal of clinical and experimental neuropsychology.

[7]  O. Hikosaka,et al.  Switching from automatic to controlled action by monkey medial frontal cortex , 2007, Nature Neuroscience.

[8]  W. Reich Diagnostic interview for children and adolescents (DICA) , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[9]  Jan R. Wiersema,et al.  Context-dependent Dynamic Processes in Attention Deficit/Hyperactivity Disorder: Differentiating Common and Unique Effects of State Regulation Deficits and Delay Aversion , 2010, Neuropsychology Review.

[10]  R. Barkley Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. , 1997, Psychological bulletin.

[11]  C. Frisby,et al.  Hispanic Test-Session Behavior on the Woodcock Johnson Psychoeducational Battery— Third Edition , 2007 .

[12]  Ian H. Robertson,et al.  Dissecting the attention deficit hyperactivity disorder (ADHD) phenotype: Sustained attention, response variability and spatial attentional asymmetries in relation to dopamine transporter (DAT1) genotype , 2005, Neuropsychologia.

[13]  Bharat B. Biswal,et al.  Competition between functional brain networks mediates behavioral variability , 2008, NeuroImage.

[14]  L. C. Bidwell,et al.  Testing for Neuropsychological Endophenotypes in Siblings Discordant for Attention-Deficit/Hyperactivity Disorder , 2007, Biological Psychiatry.

[15]  J. C. Johnston,et al.  Chronometric Evidence for Central Postponement in Temporally Overlapping Tasks , 2003 .

[16]  J. Buitelaar,et al.  Speed, Variability, and Timing of Motor Output in ADHD: Which Measures are Useful for Endophenotypic Research? , 2007, Behavior genetics.

[17]  P. Sham,et al.  Reaction time performance in ADHD: improvement under fast-incentive condition and familial effects , 2007, Psychological Medicine.

[18]  Stewart H. Mostofsky,et al.  Increased intra-individual reaction time variability in attention-deficit/hyperactivity disorder across response inhibition tasks with different cognitive demands , 2009, Neuropsychologia.

[19]  Alan C. Evans,et al.  Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation , 2007, Proceedings of the National Academy of Sciences.

[20]  Stewart H Mostofsky,et al.  Moderate variability in stimulus presentation improves motor response control , 2009, Journal of clinical and experimental neuropsychology.

[21]  W. Reich,et al.  Diagnostic Interview for Children and Adolescents , 2002 .

[22]  S. Pliszka The Neuropsychopharmacology of Attention-Deficit/Hyperactivity Disorder , 2005, Biological Psychiatry.

[23]  James J. Pekar,et al.  Functional Magnetic Resonance Imaging Evidence for Abnormalities in Response Selection in Attention Deficit Hyperactivity Disorder: Differences in Activation Associated with Response Inhibition but Not Habitual Motor Response , 2008, Journal of Cognitive Neuroscience.

[24]  Marina Vannucci,et al.  Decomposing Intra-Subject Variability in Children with Attention-Deficit/Hyperactivity Disorder , 2008, Biological Psychiatry.

[25]  H. Geurts,et al.  The top and the bottom of ADHD: a neuropsychological perspective , 2003, Neuroscience & Biobehavioral Reviews.

[26]  E. L. Mortensen,et al.  Do Attention Deficits Influence IQ Assessment in Children and Adolescents With ADHD? , 2009, Journal of attention disorders.

[27]  M. Barnes,et al.  Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders , 2009, Journal of the International Neuropsychological Society.

[28]  Stewart H. Mostofsky,et al.  Response Inhibition and Response Selection: Two Sides of the Same Coin , 2008, Journal of Cognitive Neuroscience.

[29]  D. Gilden,et al.  Response Variability in Attention-Deficit Disorders , 2007, Psychological science.

[30]  J. Pekar,et al.  Functional brain correlates of response time variability in children , 2007, Neuropsychologia.

[31]  D. Zee,et al.  Oculomotor anomalies in attention-deficit/hyperactivity disorder: evidence for deficits in response preparation and inhibition. , 2009, Journal of the American Academy of Child and Adolescent Psychiatry.

[32]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[33]  Christoph Klein,et al.  Intra-Subject Variability in Attention-Deficit Hyperactivity Disorder , 2006, Biological Psychiatry.

[34]  P. Asherson,et al.  Why cognitive performance in ADHD may not reveal true potential: Findings from a large population-based sample , 2009, Journal of the International Neuropsychological Society.