Israel: To Your Health

Pay attention: A simple discovery tool for ADHD

eyeball

By Janis Siegel, Jewish Sound Correspondent

Israeli researchers from Tel Aviv University, the University of Haifa and the Goldschleger Eye Research Institute at Sheba Medical Center, Tel Hashomer, found what they’ve called a “foolproof” method of diagnosing children with Attention Deficit Hyperactivity Disorder. Given ADHD’s uncodified set of symptoms, its unknown causes, and the many side effects of the methamphetamine-based drugs used to treat children who are diagnosed with it, according to the National Institutes of Health, it would be more than worthwhile for parents to direct their attention to the results of this newly published study, which simply observes a sufferer’s micro-sized eye movements.

Although the study, published by Dr. Moshe Fried from TAU’s Sackler Faculty of Medicine in the May 2014 issue of the journal “Vision Research,” recommended using these drugs for the treatment of ADHD because its study reaffirmed they work. The reduction of misdiagnosed children who won’t be exposed to amphetamines and stimulants like Adderall, and methylphenidate, the generic name for Ritalin and Concerta, could be significant.

“We had two objectives going into this research,” Fried said in a university statement. Fried has been diagnosed with adult ADHD according to the report. “The first was to provide a new diagnostic tool for ADHD, and the second was to test whether ADHD medication really works — and we found that it does.”

A simple and inexpensive 22-minute interval exercise can accurately diagnose the disorder.

“This test is affordable and accessible,” said Fried, “rendering it a practical and foolproof tool for medical professionals. Eye movements tracked in this test are involuntary, so they constitute a sound physiological marker of ADHD.”

Researchers recorded eye and eyelid movements, known as oculomotor movements, in two groups of 22 ADHD-diagnosed patients. One group was given Ritalin and the other received no medication.

Along with a third control group of 22 non-ADHD subjects, they all took the Variables of Attention Test, where each was measured against a known standard involuntary eye movement rate to show which attention-related mechanisms are affected by ADHD and to compare with the other groups.

Researchers found that the average small, involuntary, twitchy movements, called microsaccades, and the blink rates were higher in the ADHD groups. They also increased over the 22-minute period in both the medicated and the unmedicated groups, but in much quicker increments in the unmedicated group.

“With medication,” wrote Fried in the study report, “the level and time course of the microsaccade rate were fully normalized to the control level, regardless of the time interval within trials. We suggest that ADHD subjects fail to maintain sufficient levels of arousal during a simple and prolonged task, which limits their ability to dynamically allocate attention while anticipating visual stimuli. This impairment normalizes with medication and its oculomotor quantification could potentially be used for differential diagnosis.”

According to the U.S. Centers for Disease Control and Prevention, 11 percent of children between 4 and 17 years old were diagnosed with ADHD in 2011. That’s nearly 6 million children in 2014 population figures.

However, the U.S. National Institute of Drug Abuse has expressed concerns about serious concurrent side effects and long-term effects in the brains of those taking methamphetamines. The drugs can also change the function of the brain and the body of users, the agency said.

Because it increases the brain’s output of dopamine, the “feel good” neurotransmitter, users “crash” when stopping it and want to feel good again, eventually wanting more due to damaged dopamine neurons. Even small doses can cause sleeplessness, loss of appetite, higher blood pressure, and a faster heartbeat, while users can also become more aggressive and irritable.

Researchers have also discovered that three years after stopping the drug, dopamine neurons were still damaged. To date, it is not known if they recover.

A 2008 study published in “Child and Adolescent Psychiatric Clinics of North America” cites evidence that treating preschoolers would curb the onset of ADHD earlier, but admitted that the long-term effects of treating children that young are unknown.

And a large 2014 study, the Premarket Safety and Efficacy Studies for ADHD Medications in Children, which looked at 32 clinical trials to recommend or reject the approval of 20 new ADHD drugs before the drugs were marketed, expressed pessimism.

That study evaluated the number of participants in the trials and documented the subjects’ length of exposure in the ADHD drug trials before the drugs could be prescribed.

“It is unclear to what extent the long-term safety and efficacy of ADHD drugs have been evaluated prior to their market authorization,” concluded the study.

 

Longtime Jewish Sound correspondent and freelance journalist Janis Siegel has covered international health research for SELF magazine and campaigns for Fred Hutchinson Cancer Research Center.