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The aims of this study are to evaluate auditory sensitivity in teenagers with ADHD using acoustic reflex thresholds (ART) and to examine the effects of ADHD stimulant medication on ART.
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children. Besides core ADHD symptoms (inattentiveness, hyperactivity, impulsivity), ADHD also affects the ability to perceive and process sounds. Both hypersensitivity and hyposensitivity to loud sounds are common symptoms in ADHD patients. With stimulant medication, individuals with ADHD become more tolerant of loud noise than when they were non-medicated. It remains unknown exactly how stimulant medication alters the loudness perception. The proposed study will use the acoustic reflex to objectively measure auditory sensitivity to loud sounds. The aims of this study are to evaluate auditory sensitivity in patients with ADHD using acoustic reflex thresholds (ART) and to examine the effects of ADHD stimulant medication on ART. Eligible participants will participate in two sessions (off-med and on-med conditions) conducted on the same day. ADHD patients will be asked to come to the laboratory before taking their ADHD medication. The investigators will repeat three tests before and after taking stimulant medication. The investigators will also conduct screening tests during and between the first and second sessions. The investigators will compare a difference between the two independent groups (ADHD vs. Control) and compare a within subject difference between medication conditions (on-med vs. off-med).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ADHD | Adolescents, male or female, ages 13-19, diagnosed with ADHD, all subtypes, based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and under treatment with a stimulant medication with the same drug and dosage for at least 12 months before their study participation date |
| |
| Control | Adolescents, male or female, ages 13-19, with normal health status and development |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ADHD stimulants, for example, amphetamine, dexmethylphenidate, dextroamphetamine, methylphenidate | Drug | Both ADHD and control groups of subjects will participate in 2 sessions (on-med and off-med conditions) conducted on the same day. ADHD group will be asked to come to the laboratory in the morning before taking their morning ADHD stimulant medication. They will be tested before and after taking their ADHD medication (off-med and on-med conditions). The investigators will observe changes between the two conditions. |
| Measure | Description | Time Frame |
|---|---|---|
| Acoustic reflex | Acoustic reflex thresholds in each ear | through study completion, an average of 1 year |
| Loudness discomfort level | Average loudness levels judged as uncomfortably loud sounds by each participant | through study completion, an average of 1 year |
| Speech perception in noise | Speech perception scores in each ear measured in two separate sessions | through study completion, an average of 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Tympanogram | Results of tympanometry (type, volume, pressure, compliance, gradient) to measure middle ear function | through study completion, an average of 1 year |
| Otoacoustic emissions | Measure of inner ear function |
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Inclusion Criteria:
Inclusion criteria for all:
Additional inclusion criteria for ADHD group:
Exclusion Criteria:
Additional exclusion criteria for the ADHD group
Additional exclusion criteria for the control group
• Treatment with any psychotropic medication
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Adolescents with ADHD and typically developing adolescents
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| Name | Affiliation | Role |
|---|---|---|
| Kyoko Nagao, PhD | Nemours | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nemours Children's Health | Wilmington | Delaware | 19803 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36913518 | Derived | Sydenstricker S, Moore A, Nagao K. Comparison of Fidgeting in Adolescents with Attention-Deficit/Hyperactivity Disorder Between Before and After Stimulant Medication Intake. J Child Adolesc Psychopharmacol. 2023 May;33(4):143-148. doi: 10.1089/cap.2022.0080. Epub 2023 Mar 10. |
| Label | URL |
|---|---|
| Teenagers with ADHD may perceive loud sounds in a different way. Acoustical Society of America Press Room. | View source |
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|
| through study completion, an average of 1 year |
| NIH Toolbox Cognition testing | Measures of cognitive functions | through study completion, an average of 1 year |
| Hearing screening | Pure-tone hearing test to measure hearing sensitivity | through study completion, an average of 1 year |
| Sensory profile questionnaire | Sensory processing assessment | through study completion, an average of 1 year |
| Fidgeting | Measure of wrist movements during the testing | through study completion, an average of 1 year |
| ID | Term |
|---|---|
| D001289 | Attention Deficit Disorder with Hyperactivity |
| ID | Term |
|---|---|
| D019958 | Attention Deficit and Disruptive Behavior Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D000661 | Amphetamine |
| D064699 | Dexmethylphenidate Hydrochloride |
| D003913 | Dextroamphetamine |
| D008774 | Methylphenidate |
| C090411 | Adderall |
| D000069478 | Lisdexamfetamine Dimesylate |
| ID | Term |
|---|---|
| D000662 | Amphetamines |
| D010627 | Phenethylamines |
| D005021 | Ethylamines |
| D000588 | Amines |
| D009930 | Organic Chemicals |
| D010648 | Phenylacetates |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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