Disentangling early versus late audiovisual integration in adult ADHD: a combined behavioural and resting-state connectivity study – ScienceOpen
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      Disentangling early versus late audiovisual integration in adult ADHD: a combined behavioural and resting-state connectivity study

      research-article
      , MSc , , MD, PhD, , PhD, , PhD, , PhD, , MD, PhD
      Journal of Psychiatry & Neuroscience : JPN
      CMA Joule Inc.

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          Abstract

          Background:

          Studies investigating sensory processing in attention-deficit/hyperactivity disorder (ADHD) have shown altered visual and auditory processing. However, evidence is lacking for audiovisual interplay — namely, multisensory integration. As well, neuronal dysregulation at rest (e.g., aberrant within- or between-network functional connectivity) may account for difficulties with integration across the senses in ADHD. We investigated whether sensory processing was altered at the multimodal level in adult ADHD and included resting-state functional connectivity to illustrate a possible overlap between deficient network connectivity and the ability to integrate stimuli.

          Methods:

          We tested 25 patients with ADHD and 24 healthy controls using 2 illusionary paradigms: the sound-induced flash illusion and the McGurk illusion. We applied the Mann–Whitney U test to assess statistical differences between groups. We acquired resting-state functional MRIs on a 3.0 T Siemens magnetic resonance scanner, using a highly accelerated 3-dimensional echo planar imaging sequence.

          Results:

          For the sound-induced flash illusion, susceptibility and reaction time were not different between the 2 groups. For the McGurk illusion, susceptibility was significantly lower for patients with ADHD, and reaction times were significantly longer. At a neuronal level, resting-state functional connectivity in the ADHD group was more highly regulated in polymodal regions that play a role in binding unimodal sensory inputs from different modalities and enabling sensory-to-cognition integration.

          Limitations:

          We did not explicitly screen for autism spectrum disorder, which has high rates of comorbidity with ADHD and also involves impairments in multisensory integration. Although the patients were carefully screened by our outpatient department, we could not rule out the possibility of autism spectrum disorder in some participants.

          Conclusion:

          Unimodal hypersensitivity seems to have no influence on the integration of basal stimuli, but it might have negative consequences for the multisensory integration of complex stimuli. This finding was supported by observations of higher resting-state functional connectivity between unimodal sensory areas and polymodal multisensory integration convergence zones for complex stimuli.

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          Most cited references63

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          The assessment and analysis of handedness: The Edinburgh inventory

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            The brain's default mode network.

            The brain's default mode network consists of discrete, bilateral and symmetrical cortical areas, in the medial and lateral parietal, medial prefrontal, and medial and lateral temporal cortices of the human, nonhuman primate, cat, and rodent brains. Its discovery was an unexpected consequence of brain-imaging studies first performed with positron emission tomography in which various novel, attention-demanding, and non-self-referential tasks were compared with quiet repose either with eyes closed or with simple visual fixation. The default mode network consistently decreases its activity when compared with activity during these relaxed nontask states. The discovery of the default mode network reignited a longstanding interest in the significance of the brain's ongoing or intrinsic activity. Presently, studies of the brain's intrinsic activity, popularly referred to as resting-state studies, have come to play a major role in studies of the human brain in health and disease. The brain's default mode network plays a central role in this work.
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              The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review.

              This article describes a comprehensive meta-analysis that was conducted to estimate the prevalence of attention-deficit/hyperactivity disorder (ADHD), as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). A systematic literature review identified 86 studies of children and adolescents (N = 163,688 individuals) and 11 studies of adults (N = 14,112 individuals) that met inclusion criteria for the meta-analysis, more than half of which were published after the only previous meta-analysis of the prevalence of ADHD was completed. Although prevalence estimates reported by individual studies varied widely, pooled results suggest that the prevalence of DSM-IV ADHD is similar, whether ADHD is defined by parent ratings, teacher ratings, or a best estimate diagnostic procedure in children and adolescents (5.9-7.1 %), or by self-report measures in young adults (5.0 %). Analyses of diagnostic subtypes indicated that the predominantly inattentive type is the most common subtype in the population, but individuals with the combined type are more likely to be referred for clinical services. Additional research is needed to determine the etiology of the higher prevalence of ADHD in males than females and to clarify whether the prevalence of ADHD varies as a function of socioeconomic status or ethnicity. Finally, there were no significant prevalent differences between countries or regions of the world after controlling for differences in the diagnostic algorithms used to define ADHD. These results provide important support for the diagnostic validity of ADHD, and argue against the hypothesis that ADHD is a cultural construct that is restricted to the United States or any other specific culture.
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                Author and article information

                Journal
                J Psychiatry Neurosci
                J Psychiatry Neurosci
                jpn
                Journal of Psychiatry & Neuroscience : JPN
                CMA Joule Inc.
                1180-4882
                1488-2434
                Sep-Oct 2021
                21 September 2021
                : 46
                : 5
                : E528-E537
                Affiliations
                From the Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany (Schulze, Aslan, Lux, Philipsen); Biopsychology and Cognitive Neuroscience, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany (Schulze); the German Centre for Neurodegenerative Diseases (DZNE), Bonn, Germany (Stöcker, Stirnberg); and the Department of Physics and Astronomy, University of Bonn, Bonn, Germany (Stöcker)
                Author notes
                Correspondence to: M. Schulze, Department of Psychiatry and Psychotherapy, University of Bonn, Germany, D-53127 Bonn; marcel.schulze@ 123456ukbonn.de
                [*]

                These authors contributed equally to this work.

                Article
                46-5-e528
                10.1503/jpn.210017
                8526154
                34548387
                dbe074b4-40a0-4f18-93a9-e5ed0dadd383
                © 2021 CMA Joule Inc. or its licensors

                This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/

                History
                : 20 January 2021
                : 27 May 2021
                : 21 June 2021
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                Research Paper

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