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Auditory Distraction in ADHD: From Behaviour to the Brain
Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.ORCID iD: 0000-0001-6409-6943
2022 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Auditiv distraktion vid Adhd : Från beteende till hjärna (Swedish)
Abstract [en]

ADHD is a heterogenous disorder encompassing neurodevelopmental deficits in cognitive control. Auditory distraction is a common clinically reported symptom in ADHD, yet empirical research investigating the manifestation of auditory distraction in the disorder is remarkably scarce. Findings from cognitive hearing science highlight the crucial role cognitive control plays in an individual’s ability to gate, attenuate and/or compensate for auditory distraction. However the field is yet to extensively test hypotheses in normal hearing populations with neurodevelopmental deficits in cognitive control such as ADHD. This thesis contributes to narrowing the gap within these two fields of research by studying auditory distraction in this clinical population to a greater extent than previous reports in the literature.

Using a combination of both behavioural and neuroimaging methods, the research presented here was able to show that adults and adolescents with ADHD are inherently more susceptible to auditory distraction than their non-ADHD counterparts. At the behavioural level, impaired task performance due to auditory distraction was more likely to manifest in ADHD participants when the working memory system was under high processing load. At the neural level, functional aberrancy in auditory attention was evident at early stages of sensory processing in a variety of tasks, implicating both exogenous and endogenous control systems in ADHD. Furthermore, the distribution of ADHD-symptom severity across participants was shown to correlate with increases in both cortical activity to auditory distractors and intrinsic functional connectivity between auditory and exogenous attention networks.

In line with evidence from cognitive hearing science, the general findings of this thesis demonstrate that cognitive control plays an important role in the ability to perceive sound under suboptimal listening conditions and hamper distraction. In addition, findings challenge theories of ADHD that question the extent in which sensory-related attentional control is impaired. More empirical research on the auditory modality in ADHD is therefore encouraged in order to revise models, improve diagnostic tools, and develop evidence-based interventions targeting study/work environments.

Abstract [sv]

Adhd är en heterogen neuropsykiatrisk funktionsnedsättning som kännetecknas av nedsatt kognitiv kontroll. Ett vanligt förekommande symptom vid adhd är ljudöverkänslighet, vilket innebär en ökad känslighet för distraherande ljud, men empirisk forskning kring ljudkänslighetens roll i adhd är anmärkningsvärt knapphändig. Forskning från kognitiv hörselvetenskap belyser den viktiga roll kognitiv kontroll spelar i en individs förmåga att filtrera, dämpa och/eller kompensera för ljudöverkänslighet hos personer med hörselnedsättningar. Emellertid saknas det forskning kring hur detta fungerar hos normalhörande personer med nedsättningar i kognitiv kontroll till följd av neuropsykiatriska funktionsnedsättningar så som adhd. Målet med denna avhandling är att bidra till att minska kunskapsklyftan inom dessa två forskningsområden genom att studera känsligheten för distraherande ljud i denna kliniska population.

Genom att kombinera beteende- och hjärnavbildningsmetoder framkom att vuxna och ungdomar med adhd-diagnos påverkas mer av distraherande ljud än personer utan adhd. På beteendenivån uppvisade adhd-deltagare svårigheter med distraherande ljud främst när arbetsminnessystemet var under hög belastning. På neural nivå framkom funktionella avvikelser under tidig auditiv bearbetning för en mängd olika uppgifter. Detta tyder på störningar i både exogena och endogena kontrollsystem i adhd. Det fanns också samband mellan adhd-symptomens svårighetsgrad och neurala förändringar, där ökande mängd symptom hängde samman med såväl ökad kortikal aktivitet som svar på distraherande ljud som ökade neurala kopplingar mellan auditiva områden och exogena uppmärksamhetsnätverk.

I linje med teorier från kognitiv hörselvetenskap visar fynden i den här avhandlingen att kognitiv kontroll spelar en viktig roll i förmågan att uppfatta ljud under suboptimala lyssningsförhållanden samt att hantera distraherande ljud. Dessutom utmanar resultaten teorier som ifrågasätter huruvida sensorisk uppmärksamhetskontroll är nedsatt i adhd. Mer empirisk forskning om den auditiva domänens roll i adhd behövs för att revidera modeller, förbättra diagnostiska verktyg och utveckla evidensbaserade interventioner inriktade på studie- och arbetsmiljöer.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2022. , p. 45
Series
Linköping Studies in Arts and Sciences, ISSN 0282-9800 ; 834Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 107
Keywords [en]
Auditory distraction, Cognitive control, Attention, Working memory, ADHD
Keywords [sv]
Auditiv distraktion, Kognitiv kontroll, Uppmärksamhet, Arbetsminne, Adhd
National Category
Psychology (excluding Applied Psychology) Neurosciences
Identifiers
URN: urn:nbn:se:liu:diva-183960DOI: 10.3384/9789179293031ISBN: 9789179293024 (print)ISBN: 9789179293031 (electronic)OAI: oai:DiVA.org:liu-183960DiVA, id: diva2:1648088
Public defence
2022-04-29, TEMCAS, Building T, Campus Valla, Linköping, 14:00 (English)
Opponent
Supervisors
Available from: 2022-03-29 Created: 2022-03-29 Last updated: 2023-01-30Bibliographically approved
List of papers
1. Speech Processing Difficulties in Attention Deficit Hyperactivity Disorder
Open this publication in new window or tab >>Speech Processing Difficulties in Attention Deficit Hyperactivity Disorder
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2019 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 10, article id 1536Article in journal (Refereed) Published
Abstract [en]

The large body of research that forms the ease of language understanding (ELU) model emphasizes the important contribution of cognitive processes when listening to speech in adverse conditions; however, speech-in-noise (SIN) processing is yet to be thoroughly tested in populations with cognitive deficits. The purpose of the current study was to contribute to the field in this regard by assessing SIN performance in a sample of adolescents with attention deficit hyperactivity disorder (ADHD) and comparing results with age-matched controls. This population was chosen because core symptoms of ADHD include developmental deficits in cognitive control and working memory capacity and because these top-down processes are thought to reach maturity during adolescence in individuals with typical development. The study utilized natural language sentence materials under experimental conditions that manipulated the dependency on cognitive mechanisms in varying degrees. In addition, participants were tested on cognitive capacity measures of complex working memory-span, selective attention, and lexical access. Primary findings were in support of the ELU-model. Age was shown to significantly covary with SIN performance, and after controlling for age, ADHD participants demonstrated greater difficulty than controls with the experimental manipulations. In addition, overall SIN performance was strongly predicted by individual differences in cognitive capacity. Taken together, the results highlight the general disadvantage persons with deficient cognitive capacity have when attending to speech in typically noisy listening environments. Furthermore, the consistently poorer performance observed in the ADHD group suggests that auditory processing tasks designed to tax attention and working memory capacity may prove to be beneficial clinical instruments when diagnosing ADHD.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA, 2019
Keywords
attention deficit hyperactivity disorder; speech in noise; speech processing; cognitive control; working memory; auditory; adolescents
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:liu:diva-159057 (URN)10.3389/fpsyg.2019.01536 (DOI)000474205400001 ()
Note

Funding Agencies|Swedish Research Council [2015-01917]

Available from: 2019-07-22 Created: 2019-07-22 Last updated: 2022-03-29
2. The Effects of Working Memory Load on Auditory Distraction in Adults With Attention Deficit Hyperactivity Disorder
Open this publication in new window or tab >>The Effects of Working Memory Load on Auditory Distraction in Adults With Attention Deficit Hyperactivity Disorder
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2021 (English)In: Frontiers in Human Neuroscience, E-ISSN 1662-5161, Vol. 15, article id 771711Article in journal (Refereed) Published
Abstract [en]

Cognitive control provides us with the ability to inter alia, regulate the locus of attention and ignore environmental distractions in accordance with our goals. Auditory distraction is a frequently cited symptom in adults with attention deficit hyperactivity disorder (aADHD)-yet few task-based fMRI studies have explored whether deficits in cognitive control (associated with the disorder) impedes on the ability to suppress/compensate for exogenously evoked cortical responses to noise in this population. In the current study, we explored the effects of auditory distraction as function of working memory (WM) load. Participants completed two tasks: an auditory target detection (ATD) task in which the goal was to actively detect salient oddball tones amidst a stream of standard tones in noise, and a visual n-back task consisting of 0-, 1-, and 2-back WM conditions whilst concurrently ignoring the same tonal signal from the ATD task. Results indicated that our sample of young aADHD (n = 17), compared to typically developed controls (n = 17), had difficulty attenuating auditory cortical responses to the task-irrelevant sound when WM demands were high (2-back). Heightened auditory activity to task-irrelevant sound was associated with both poorer WM performance and symptomatic inattentiveness. In the ATD task, we observed a significant increase in functional communications between auditory and salience networks in aADHD. Because performance outcomes were on par with controls for this task, we suggest that this increased functional connectivity in aADHD was likely an adaptive mechanism for suboptimal listening conditions. Taken together, our results indicate that aADHD are more susceptible to noise interference when they are engaged in a primary task. The ability to cope with auditory distraction appears to be related to the WM demands of the task and thus the capacity to deploy cognitive control.

Place, publisher, year, edition, pages
Frontiers Media SA, 2021
Keywords
attention deficit hyperactivity disorder; adults; attention; cognitive control; auditory distraction; salience network (SN); working memory; task-based fMRI
National Category
Neurosciences
Identifiers
urn:nbn:se:liu:diva-181986 (URN)10.3389/fnhum.2021.771711 (DOI)000729921300001 ()34916918 (PubMedID)
Available from: 2021-12-27 Created: 2021-12-27 Last updated: 2024-01-17
3. Aberrant resting-state connectivity of auditory, ventral attention/salience and default-mode networks in adults with attention deficit hyperactivity disorder
Open this publication in new window or tab >>Aberrant resting-state connectivity of auditory, ventral attention/salience and default-mode networks in adults with attention deficit hyperactivity disorder
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2022 (English)In: Frontiers in Neuroscience, ISSN 1662-4548, E-ISSN 1662-453X, Vol. 16, article id 972730.Article in journal (Refereed) Published
Abstract [en]

Background Numerous resting-state studies on attention deficit hyperactivity disorder (ADHD) have reported aberrant functional connectivity (FC) between the default-mode network (DMN) and the ventral attention/salience network (VA/SN). This finding has commonly been interpreted as an index of poorer DMN regulation associated with symptoms of mind wandering in ADHD literature. However, a competing perspective suggests that dysfunctional organization of the DMN and VA/SN may additionally index increased sensitivity to the external environment. The goal of the current study was to test this latter perspective in relation to auditory distraction by investigating whether ADHD-adults exhibit aberrant FC between DMN, VA/SN, and auditory networks. Methods Twelve minutes of resting-state fMRI data was collected from two adult groups: ADHD (n = 17) and controls (n = 17); from which the FC between predefined regions comprising the DMN, VA/SN, and auditory networks were analyzed. Results A weaker anticorrelation between the VA/SN and DMN was observed in ADHD. DMN and VA/SN hubs also exhibited aberrant FC with the auditory network in ADHD. Additionally, participants who displayed a stronger anticorrelation between the VA/SN and auditory network at rest, also performed better on a cognitively demanding behavioral task that involved ignoring a distracting auditory stimulus. Conclusion Results are consistent with the hypothesis that auditory distraction in ADHD is linked to aberrant interactions between DMN, VA/SN, and auditory systems. Our findings support models that implicate dysfunctional organization of the DMN and VA/SN in the disorder and encourage more research into sensory interactions with these major networks.

Place, publisher, year, edition, pages
Frontiers Media SA, 2022
Keywords
attention deficit hyperactivity disorder; adults; resting state; functional connectivity; default mode network; salience network; auditory network
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:liu:diva-189095 (URN)10.3389/fnins.2022.972730 (DOI)000859638200001 ()36148149 (PubMedID)
Available from: 2022-10-11 Created: 2022-10-11 Last updated: 2024-01-08

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