Can fidgeting lead to enhanced attention and emotional regulation in adult ADHD?

坐立不安是一种非常常见的行为，过度坐立不安与注意力缺陷/多动症有关 精神障碍(ADHD)。我们实验室(1)和同事(2)的研究表明，身体运动可以增强 注意缺陷多动障碍儿童的认知表现。感觉运动过敏行为可能与受损有关 觉醒在去甲肾上腺素能和多巴胺能系统中的调节(3)。该项目将评估频率是否 感觉运动行为特征与成人ADHD患者的认知和情绪反应有关， 以一种细粒度的方式，不同于其他研究。我们将测试内部的坐立不安(目标1)和访问特殊的 设计的坐立不安装置(AIM 2)调节认知和生理反应 情感上要求很高的环境。商业化的Fidget Cube、其竞争对手和 坐立不安的纺纱者认为这是可能的，但没有系统的证据来告知消费者，这是我们希望填补的一个空白。 ADHD是成年后的一个重大问题，估计有4.4%的人患有ADHD(4)。它与以下内容关联 较高的药物使用障碍、交通事故和就业挑战的比率，以及全国年度 经济影响由1,430亿元至2,660亿元不等(5)。而明显的多动症主要与 童年时期，更微妙、更细腻的频繁动作(例如，腿部动作、涂鸦、点击物体、敲击) 在成人ADHD中非常常见。人们对成人坐立不安的特征知之甚少 它可以被利用来通过使用外部设备来增强自我调节。我们的目标是： 目标1：在一项随机对照研究中评估a)固有的坐立不安和b)智能坐立不安设备的使用 改善成人ADHD患者的注意力、工作记忆、处理速度和情绪调节；目标2： 确定与成人ADHD认知和情绪调节相关的特定触摸特征 行为编码和一个原型烦躁球(由Co-I Isbister开发)，上面嵌入了压力传感器 将实时数据传输到计算机进行数据分析的烦躁表面；探索目标3：进行 坐立不安行为与认知绩效和情绪调节关系的机器学习分析 目的：1)自动识别成人ADHD患者坐立不安时出现的触摸特征；2)关联触摸序列 与认知绩效测量和；3)建议坐立不安的策略，应该证明是有效的 在特定的情况下。这个项目将建立在PiSchweitzer之前的工作基础上，她在ADHD，临床上的专业知识 翻译研究和认知神经科学和Co-I Isbister，拥有计算机科学和 工程师，他开发了启用传感器的智能坐立不安设备，目标是改善自我调节 情绪和注意力(6-9)；Co-I Shapiro(10)，在分析坐立不安行为方面具有机器学习专业知识。 该项目高度响应NIMH战略计划目标3，因为它将为致力于 开发基于行为和生理标记的新干预措施，为个人量身定做。

Fidgeting is a highly common behavior, with excessive fidgeting associated with attention-deficit/hyperactivity disorder (ADHD). Studies from our laboratory (1) and colleagues (2) suggest physical movement can enhance cognitive performance in children with ADHD. Hyper-sensorimotor behavior may be related to impaired regulation of arousal in the noradrenergic and dopaminergic systems (3). This project will assess if frequency and characteristics of sensorimotor behavior relates to cognitive and emotional response in adults with ADHD, in a fine-grained manner, unlike other studies. We will test if intrinsic fidgeting (Aim 1) and access to a specially designed fidget device (Aim 2) modulates behavioral and physiological response in cognitively and emotionally-demanding contexts. The hype of the commercially available Fidget Cube, its competitors and fidget spinners suggest it might, but there is no systematic evidence to inform consumers, a gap, we aim to fill. ADHD is a significant problem in adulthood, with estimates of 4.4% in the population (4). It is associated with higher rates of substance use disorders, traffic accidents and employment challenges and a national annual economic impact ranging from $143 to $266 billion (5). While overt hyperactivity is mostly associated with childhood, subtler, finer-grained frequent movements (e.g., leg movements, doodling, clicking objects, tapping) are highly common in adult ADHD. Little is known about the characteristics of fidgeting in adulthood or whether it can be harnessed to enhance self-regulation with the use of an external device. Our aims are as follows: Aim 1: Assess in a randomized controlled study if a) intrinsic fidgeting and b) use of a smart fidget device improves attention, working memory, processing speed and emotional regulation in adult ADHD; Aim 2: Identify specific touch characteristics associated with cognitive and emotional regulation in adult ADHD using behavioral coding and a prototype fidget ball (developed by Co-I Isbister) with embedded pressure sensors on the fidget surface transmitting real time data to a computer for data analysis; Exploratory Aim 3: Conduct a machine learning analysis of fidgeting behavior in relation to cognitive performance and emotional regulation to: 1) automate recognition of touch features present in fidgeting in adult ADHD; 2) correlate touch sequences with cognitive performance measures and; 3) recommend fidgeting strategies that should prove effective in a given situation. This project will build upon prior work by PI Schweitzer, with her expertise in ADHD, clinical translational research and cognitive neuroscience and Co-I Isbister, with expertise in computer science and engineering, who developed sensor-enabled, smart fidget devices with the goal of improving self-regulation of mood and attention (6-9); Co-I Shapiro (10) with machine learning expertise in analyzing fidgeting behavior. This project is highly responsive to NIMH Strategic Plan Objective 3 as it will inform researchers working to develop new interventions based on behavioral and physiological markers, tailored to the individual.