Temporal Characteristics Of Response Inhibition Dysfunction In Children With ADHD

Objective:The temporal characteristics of attention deficit/hyperactivity disorder（ADHD）have been found,and the response inhibition function is closely related to sustained attention,but the temporal characteristics of response inhibition deficits in ADHD are unclear.This study investigates the temporal characteristics of interference inhibition,ongoing response inhibition and prepotent response inhibition deficits in children with ADHD and compares with typically developing children based on time series analysis.This study introduces temporal variables to examine the relationship between response inhibition deficits and sustained attention deficits.It provides an objective and accurate basis for the clinical diagnosis of ADHD and a practical and theoretical basis for the development of more personalized rehabilitation training programs for attention deficit and response inhibition deficits.Method:In the first study,neuropsychological assessments were conducted on children aged 6～13 years with ADHD（n=48）who met the DSM-V diagnostic criteria and typically developing children（n=33）whose age,gender,and education level matched those of children with ADHD.Interference inhibition,ongoing response inhibition,and prepotent response inhibition functions were assessed in both groups of children using the Simon task,the stop-signal task,and the inhibitory conflict task,respectively,with each task lasting 30 minutes and divided into five time series of 6 minutes each.Study 2used a visual CPT task to assess the temporal characteristics of sustained attention deficits in children with ADHD and their differences from normal children.In addition,the correlations between the response inhibition function time series data collected in Study1 and the sustained attention time series data in Study 2 were analyzed by generalized estimating equations（GEE）.Results:Study1:1.In the Simon task evaluating the error rate effect size remained relatively stable in the control group but gradually decreased in the ADHD group across time sequences.The error rate effect sizes were significantly higher in the ADHD group than in the control group from sequence 1 to sequence 4（p<0.05）.2.The error rate remained relatively stable in the control group and in the ADHD group across time sequences.In time series 1 to 5,the error rate of the stop-signal task was significantly higher in the ADHD group than in the normal children’s group（p<0.001）.3.In the inhibitory conflict task,the error rate remained relatively stable in the control group at different time sequences,and gradually increased in the ADHD group,and the error rate tended to be stable from time sequence 3.In time series 1 to series 5,the error rate of the conflict inhibition task was significantly higher in the ADHD group than control（p<0.001）.Study2:1.In the visual CPT task,the omission rate in the ADHD group increased significantly from sequence 1 to sequence 3,and became stable after the peak in time sequence 3;the omission rate of the control group also gradually increased but the rising trend was less significant than that of the ADHD group.From time series 1 to 5,the underreporting and false alarm rates were significantly higher in the ADHD group than control group（p<0.001）.The false alarm rates in the ADHD and normal children remained relatively stable over time.2.The results of the GEE model showed that the error rate effect size of Simon task was positively correlated with the omission rate of CPT in children with ADHD（p<0.01）,and each percentage point increase in the error rate effect size increased the average CPT omission rate by 1.3%;the error rate of inhibitory conflict task was positively correlated with the CPT omission rate（p<0.001）,and each percentage point increase in the error rate increased the CPT omission rate by 1.5%.There was no significant correlation between the error rate of the stop-signal task and the CPT omission rate.Conclusions:1.The deficits in interference inhibition in children with ADHD are temporal in nature,and the performance of interference inhibition gradually improves over time,showing a learning effect.2.There was no temporal characteristic of ongoing response inhibition deficits in ADHD children,which was relatively stable over time.3.There was temporal characteristic of prepotent response inhibition deficits in ADHD children,which became obvious with time and stabilize from the 18^th minute onwards.4.There was temporal characteristic of sustained attention deficits in ADHD children,which becomes increasingly prominent overtime while stabilized after 18^th min.5.After taking time into account,interference inhibition deficits and prepotent response inhibition deficits in children with ADHD were positively correlated with sustained attention deficits,and ongoing response inhibition deficits were not correlated with sustained attention deficits.