Abstract:
A method of determining whether an individual has Attention Deficit Hyperactivity Disorder comprising: sampling the eye movement of a human subject during a predetermined time interval when the subject is in an inactive state to provide sampled eye movement data; and analyzing the sampled eye movement data for a pre-selected parameter, to determine whether said pre-selected parameter has a value indicative of ADHD.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS  
       [0001]    This patent application claims the benefit under 35 USC § 120 of the earlier filing date of U.S. patent application Ser. No. 09/597,610, filed Jun. 20, 2000. 
     
    
     
       FIELD OF THE INVENTION  
         [0002]    This invention relates in general to a technique for diagnosing Attention Deficit Hyperactivity Disorder (ADHD) using a biological metric such as eye saccades.  
         BACKGROUND OF THE INVENTION  
         [0003]    ADHD is the most common neurobehavioral disorder of childhood as well as among the most prevalent health conditions affecting school-aged children. Between 4% and 12% of school age children (several millions) are affected. $3 billion is spent annually on behalf of students with ADHD. Moreover, in the general population, 9.2% of males and 2.9% of females are found to have behavior consistent with ADHD. Upwards of 10 million adults may be affected.  
           [0004]    ADHD is a difficult disorder to diagnose. The core symptoms of ADHD in children include inattention, hyperactivity, and impulsivity ADHD children may experience significant functional problems, such as school difficulties, academic underachievement, poor relationships with family and peers, and low self-esteem. Adults with ADHD often have a history of losing jobs, impulsive actions, substance abuse, and broken marriages. ADHD often goes undiagnosed if not caught at an early age and affects many adults who may not be aware of the condition. ADHD has many look-alike causes (family situations, motivations) and co-morbid conditions (depression, anxiety, learning disabilities).  
           [0005]    Diagnosis of ADHD involves a process of elimination using written and verbal tests. However, there is no one objective, independent valid test for ADHD. Various objective techniques have been proposed but have not yet attained acceptance. These include:  
           [0006]    1. The eye problem called convergence insufficiency was found to be three times more common in children with ADHD than in other children by David Granet at the University of California, San Diego.  
           [0007]    2. Infrared tracking to measure difficult-to-detect movements of children during attention tests combined with functional MRI imaging of the brain were used by psychiatrists at McLean Hospital in Belmont, Mass. to diagnose ADHD in a small group of children ( Nature Medicine,  Vol. 6, No. 4, April 2000, Pages 470-473).  
           [0008]    3. Techniques based on EEG biofeedback for the diagnoses and treatment of ADHD are described by Lubar ( Biofeedback and Self - Regulation , Vol. 16, No. 3, 1991, Pages 201-225).  
           [0009]    4. U.S. Pat. No. 6,097,980, issued Aug. 1, 2000, inventor Monastra et al, discloses a quantitative electroencephalographic process assessing ADHD.  
           [0010]    5. U.S. Pat. No. 5,913,310, issued Jun. 22, 1999,inventor Brown, discloses a video game for the diagnosis and treatment of ADHD.  
           [0011]    6. U.S. Pat. No. 5,918,603, issued Jul. 6, 1999, inventor Brown, discloses a video game for the diagnosis and treatment of ADHD.  
           [0012]    7. U.S. Pat. No. 5,940,801, issued Aug. 17, 1999, inventor Brown, discloses a microprocessor such as a video game for the diagnosis and treatment of ADHD.  
           [0013]    8. U.S. Pat. No. 5,377,100, issued Dec. 27, 1994, inventors Pope et al., discloses a method of using a video game coupled with brain wave detection to treat patients with ADHD.  
           [0014]    9. Dr. Albert Rizzo of the Integrated Media Systems Center of the University of Southern California has used Virtual Reality techniques for the detection and treatment of ADHD.  
           [0015]    10. U.S. Pat. No. 6,053,739, inventors Stewart et al., discloses a method of using a visual display, colored visual word targets and colored visual response targets to administer an attention performance test.  
           [0016]    11. U.S. Pat. No. 5,377,100, issued Dec. 27, 1994, inventors Patton et al., discloses a system and of managing the psychological state of an individual using images.  
           [0017]    12. U.S. Pat. No. 6,117,075 Barnea discloses a method of measuring the depth of anesthesia by detecting the suppression of peripheral temperature variability.  
           [0018]    As discussed above, the primary method for diagnosing ADHD is the use of a bank of written and verbal assessment instruments designed to assess criteria established by American Medical Association (AMA) as described in the Diagnostic and Statistics manual—IV (DSM-IV) and administered by the school psychologist or other licensed practitioner. Most recently the American Academy of Pediatrics issued guidelines, which are widely followed (Clinical Practice Guidelines: Diagnosis of a child with Attention Deficit Hyperactivity Disorder;  Pediatrics V 5 #105 5 May 2000). In some cases those individuals who meet DSM-IV criteria for ADHD diagnosis are prescribed a drug such as Ritalin. Behavioral observations of the patient while on Ritalin are conducted to assess the impact of prescribed medication.  
           [0019]    There are several clinical biofeedback and physiology monitoring systems (e.g. Multi Trace, Bio Integrator). These systems are used by professional clinicians. A clinician monitors patient&#39;s physiologic changes and accordingly uses different protocols.  
           [0020]    U.S. patent application Ser. No. 09/597,610 describes an apparatus and method of determining whether an individual has Attention Deficit Hyperactivity Disorder by analyzing physiologic reactivity patterns (peripheral skin temperature) when the subject is asked to sit quietly in a low stimulus environment for a short period of time.  
         SUMMARY OF THE INVENTION  
         [0021]    According to the present invention, there is provided a solution to the problems and fulfillment of the needs discussed above.  
           [0022]    According to a feature of the present invention, there is provided a method of determining whether an individual has Attention Deficit Hyperactivity Disorder comprising: sampling the eye movement of a human subject during a predetermined time interval when the subject is in an inactive state to provide sampled eye movement data; and analyzing the sampled eye movement data for a pre-selected parameter, to determine whether said pre-selected parameter has a value indicative of ADHD.  
         ADVANTAGEOUS EFFECT OF THE INVENTION  
         [0023]    The invention has the following advantages.  
           [0024]    1. A technique for diagnosing ADHD is provided which is simple, inexpensive and reliable. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0025]    [0025]FIG. 1 is a diagrammatic view of the apparatus of the present invention.  
         [0026]    [0026]FIG. 2 is a block diagram of the apparatus.  
         [0027]    [0027]FIGS. 3 and 4 are graphical views useful in explaining the present invention. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0028]    According to the present invention, it has been found that a signature of ADHD is the angular acceleration of the eyeball. In a set of experiments, the angular acceleration of the eyeball was measured during the same baseline period when the subject was asked to sit quietly.  
         [0029]    As shown in FIG. 1, a subject  10  is sitting on a chair  12  viewing a blank screen  14 . The subject is at rest in an inactive state. The subject  10  is shown wearing a set of earphones  16  connected via a wire  18  to a sound generating device  19 . The earphones  16  can be used to block out ambient noise or produce a white noise intended to reduce or eliminate the audio stimulus from the environment during the test. The method described in this embodiment of the present invention places the subject in sensory deprived surroundings. The subject  10  wears a pair of glasses  20 . The glasses  20  are connected to module  21  via a wire  22 . The glasses  20  are equipped with a device  30  shown in FIG. 2 used for measuring the angular acceleration of the eyeball as described in U.S. Pat. No. 4,456,347, issued Jun. 26, 1984, inventor F. A. Stahly. The method of measuring the angular acceleration of the eyeball of the subject  10  is described in FIG. 2.  
         [0030]    Referring now to FIG. 2, as described in U.S. Pat. No. 4,456,347, three light transducing elements comprising an infrared radiator in the form of a light-emitting diode (LED)  31  and a pair of infrared-sensitive photo diodes  32 , are supported in a mounting unit such as glasses  20  as shown in (FIG. 1). Appropriate wiring to a small electronic circuit (not shown) connects the light transducing elements  31  and  32 . The elements are adjusted so that radiant energy from LED  31  is directed to the surface of the eye  33  (or the closed eyelid) of the wearer so that reflections of that radiation are received by photodiodes  32 . Any slight movement of the individual&#39;s eye  33  causes a change in the reflectively of the particular area of the individual&#39;s eye  33  or closed eyelid on which the radiant energy is impinging. For instance, any resulting alteration of the patterns of tiny blood vessels in the sclera, or any minute modifications in the contours of an eyelid, will result in respective changes in such reflectively. Any such minute change in reflectively is accompanied by a corresponding change in the output signals of photodiodes  32 , which vary in amplitude in accordance with the size and duration of the saccadic movement.  
         [0031]    The output of the photodiodes  32  is fed to differential amplifier  34 . The device  30  receives the differential signal from the amplifier at point “a”. The signal is collected and then sampled at 1024 s/sec by sampling unit  35 , converted to a digital signal by A/D converter  36  and stored in a data file located in storage module  21  as shown in FIG. 1. Module  21  can be a digital computer or other type of logic and control unit. The equipment shown within the dotted border  30  can be part of a digital data acquisition system such as the DSP- 330  made by the J+J Engineering Company. Model  21  can be located at the test site or be remote from it. Thus, signals can be transmitted over a wireless channel to a remote site for analysis. The signals can also be transmitted over any telecommunication channel, telephone, cable, satellite, Internet, etc., for analysis at a remote site.  
         [0032]    Using the device described in FIG. 2, the pupillary angle of a human subject is sampled during a predetermined time interval when the subject is in an inactive state. The angular acceleration of the eye at equally spaced intervals is measured while the subject  10  stares at the blank screen  14  during the test period. The test period can be approximately 10 minutes in length. The measurement data of the angular acceleration of the eye is plotted in the form of a histogram as shown in FIGS. 3 and 4. The width of the histogram is measured at a chosen fraction of the maximum value and compared to a threshold value. Widths below the threshold value provide a diagnosis of ADHD and widths above the threshold value constitute a diagnosis of normal.  
         [0033]    Referring to FIG. 3, histograms show the eye acceleration data for 2 subjects A and B. Subject A is diagnosed with having ADHD. Subject B is diagnosed with not having ADHD. The narrower width of Subject A&#39;s histogram as compared to Subject B&#39;s histogram indicates a smaller range of eye acceleration. The width of the histogram w is measured at the 2 σ points [w=2σ], where σ is the standard deviation as defined by the following equation  
         σ        (   τ   )       =       1   n            ∑     i   =   0       i   =   n              [       a   i     -     μ        (   a   )         ]     2                               
 
         [0034]    Where a is the angular acceleration of the eye in relative units and n is the number of samples and τ is the time at the start of a temporal window containing n samples.  
         [0035]    Referring now to FIG. 4, the standard deviations of the histograms of the eye saccades measured for 7 (subjects including subjects A &amp; B shown in FIG. 3) are shown. These data were obtained by averaging the histogram widths measured from 5 windows spaced equally in time. With the exception of subject D, all subjects with ADHD diagnosis have narrower histograms then the normal subjects. The data demonstrates that the range of eye motion can be used as a diagnostic method for ADHD. When the width of a histogram as shown on the ordinate of FIG. 4) is less than a threshold value Θ the subject is diagnosed as having ADHD, when the width is greater than Θ (shown by a dotted line on FIG.  4 ) the subject is diagnosed as normal. Setting a value of 10 for Θ would give only one false positive result out of 8 test runs shown on FIG. 4, an accuracy of 87.5%.  
         [0036]    The invention has been described in detail with particular reference to certain preferred embodiments thereof but it will be understood that variations and modifications can be effected within the spirit and scope of the invention.  
                                         PARTS LIST                                10   human subject       12   chair       14   blank screen       16   earphones       18   wire       19   sound generating device       20   glasses       21   module       22   wire       30   device       31   light emitting diode (LED)       32   photodiodes       33   eye       34   amplifier       35   sampling unit       36   A/D converter