Relationship between autonomic arousal and attention orienting in children and adolescents with ADHD, autism and co-occurring ADHD and autism

Alessio Bellato; Iti Arora; Puja Kochhar; Danielle Ropar; Chris Hollis; Madeleine J Groom

doi:10.1016/j.cortex.2023.06.002

Relationship between autonomic arousal and attention orienting in children and adolescents with ADHD, autism and co-occurring ADHD and autism

Cortex. 2023 Sep:166:306-321. doi: 10.1016/j.cortex.2023.06.002. Epub 2023 Jun 28.

Authors

Alessio Bellato¹, Iti Arora², Puja Kochhar³, Danielle Ropar⁴, Chris Hollis⁵, Madeleine J Groom⁶

Affiliations

¹ School of Psychology, University of Nottingham, Malaysia; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK. Electronic address: alessio.bellato@nottingham.edu.my.
² Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
³ Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK; Neurodevelopmental Specialist Service (NeSS), Nottinghamshire Healthcare NHS Foundation Trust, Highbury Hospital, Highbury Road, Nottingham, NG6 9DR, UK.
⁴ School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
⁵ Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK; NIHR MindTech Medtech Co-operative, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK NIHR; Nottingham Biomedical Research Centre, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
⁶ Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK; Nottingham Biomedical Research Centre, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.

PMID: 37459680
DOI: 10.1016/j.cortex.2023.06.002

Abstract

Introduction: Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) may be characterized by different profiles of visual attention orienting. However, there are also many inconsistent findings emerging from the literature, probably due to the fact that the potential effect of autonomic arousal (which has been proposed to be dysregulated in these conditions) on oculomotor performance has not been investigated before. Moreover, it is not known how visual attention orienting is affected by the co-occurrence of ADHD and autism in people with a double diagnosis.

Methods: 99 children/adolescents with or without ADHD and/or autism (age 10.79 ± 2.05 years, 65% boys) completed an adapted version of the gap-overlap task (with baseline and overlap trials only). The social salience and modality of stimuli were manipulated between trials. Eye movements and pupil size were recorded. We compared saccadic reaction times (SRTs) between diagnostic groups and investigated if a trial-by-trial association existed between pre-saccadic pupil size and SRTs.

Results: Faster orienting (shorter SRT) was found for baseline compared to overlap trials, faces compared to non-face stimuli and-more evidently in children without ADHD and/or autism-for multi-modal compared to uni-modal stimuli. We also found a linear negative association between pre-saccadic pupil size and SRTs, in autistic participants (without ADHD), and a quadratic association in children with ADHD (without autism), for which SRTs were slower when intra-individual pre-saccadic pupil size was smallest or largest.

Conclusion: Our findings are in line with previous literature and indicate a possible effect of dysregulated autonomic arousal on oculomotor mechanisms in autism and ADHD, which should be further investigated in future research studies with larger samples, to reliably investigate possible differences between children with single and dual diagnoses.

Keywords: ADHD; Autism; Eye-tracking; Gap-overlap; Pupil; Visual attention.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Arousal
Attention Deficit Disorder with Hyperactivity* / complications
Attention Deficit Disorder with Hyperactivity* / diagnosis
Autism Spectrum Disorder* / complications
Autism Spectrum Disorder* / diagnosis
Autistic Disorder* / complications
Child
Eye Movements
Female
Humans
Male

Grants and funding

BRC-1215-20003/DH_/Department of Health/United Kingdom