Transcranial Doppler sonography reveals sustained attention deficits in young adults diagnosed with ADHD

The National Institute of Mental Health has recently launched the Research Domain Criteria framework that seeks to inform clinical classification schemes by elevating the status of neuroscience research in the diagnosis of mental disorders. The current research seeks to contribute to that initiative by using a neurophysiological measure, transcranial Doppler sonography that has been shown to be sensitive to decrements in sustained attention and may provide an additional biomarker of executive dysfunction in ADHD. Twenty-seven participants performed a 12-min vigilance task while cerebral blood flow velocity (CBFV) was recorded. Thirteen participants were included in an ADHD condition if they had been formally diagnosed with ADHD. The remaining 14 participants who had never been formally diagnosed with ADHD were included in the control condition. Participants that had been diagnosed with ADHD demonstrated a steeper decrement in performance accuracy, a steeper decrement in perceptual sensitivity, and employed a more liberal response bias over time as compared to the control participants. Critically, the decrement in CBFV was steeper for participants previously diagnosed with ADHD than those who were not. Moreover, CBFV was found to better predict decreases in sensitivity and hit rate, as well as increases in liberal responding above and beyond self-reported ADHD symptoms. Results suggest that CBFV can be used to index failures of executive control in ADHD and can predict response strategy, and that the measure may provide an additional index of the sustained attention deficits associated with ADHD compared to traditional diagnostic methods.