Impaired sensory-motor integration in children with attention-deficit/hyperactivity disorder during visual search

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-age children. Abnormal sensory-motor integration, such as concurrent visuomotor selection, is a prominent feature of ADHD. However, underlying pathophysiological substrates of impaired sensory-motor integration in childhood ADHD remain unclear. Identifying neural markers of cognitive impairment in children with ADHD is vital for the early assisted diagnosis and the selection of intervention targets.

We collected electroencephalography (EEG) signals from 70 children with ADHD and 65 matched typically developing (TD) children while performing a visual search task. Oscillation-based multivariate pattern decoding was used to investigate visuomotor coordination during spatial attention.

Compared with TD children, children with ADHD showed impairments in accuracy, response time, and response time variability. Multivariate machine learning revealed that the ADHD group showed deficits in alpha (visual-related) and beta (motor-related) power-based decoding accuracy, indicating the impaired sensory orienting and motor preparation. Importantly, children with ADHD exhibited a delay between alpha and beta decoding, suggesting a deficit of concurrent visuomotor coordination. However, this visuomotor asynchrony was absent in TD children. Furthermore, the degree of visuomotor asynchrony between alpha and beta decoding was predictive of behavioral impairments and symptom severity in children with ADHD.

These observations reveal that impaired concurrent visuomotor coordination might be a potential neural marker of impaired sensory-motor integration in children with ADHD, further advancing the understanding of cognitive deficits, and providing potential research directions for the early diagnosis and optimization of intervention in neurodevelopmental disorders.