Stimulant Medication Effects on Auditory Sensitivity in Teens With ADHD

Completed

Conditions: Attention Deficit Hyperactivity Disorder
Attention Deficit Disorder
Attention Deficit Disorder With Hyperactivity

Interventions: Drug: ADHD stimulants, for example, amphetamine, dexmethylphenidate, dextroamphetamine, methylphenidate

Brief Summary: 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.

Detailed Description: 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).

Recruitment & Eligibility

Inclusion Criteria

Inclusion criteria for all:

Additional inclusion criteria for ADHD group:

Participants must meet diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD), all subtypes, based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Stimulant medication with the same drug and dosage for at least 1 year before their enrollment date

Exclusion Criteria

History of any major neurological disorders (e.g. seizures excluding febrile seizure under age 6 years, tumors, brain injury, cerebral palsy, tic disorders)
History of any other major neuropsychiatric disorders (e.g. autism spectrum disorder, mood dysregulation),
Presence of pressure equalization tubes in either ear
Documented hearing impairment 20 decibel or higher hearing loss in either ear
Estimated low cognitive function based on the NIH Toolbox Cognition age-corrected scores (<70)

Additional exclusion criteria for the ADHD group

Treatment with any psychotropic medications other than stimulants
Treatment with any ADHD medication other than stimulants (e.g. alpha-agonists, norepinephrine reuptake inhibitors)

Additional exclusion criteria for the control group

• Treatment with any psychotropic medication

Arm && Interventions

Group	Intervention	Description
ADHD	ADHD stimulants, for example, amphetamine, dexmethylphenidate, dextroamphetamine, methylphenidate	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

Primary Outcome Measures

Name	Time	Method
Acoustic reflex	through study completion, an average of 1 year	Acoustic reflex thresholds in each ear
Speech perception in noise	through study completion, an average of 1 year	Speech perception scores in each ear measured in two separate sessions
Loudness discomfort level	through study completion, an average of 1 year	Average loudness levels judged as uncomfortably loud sounds by each participant

Secondary Outcome Measures

Name	Time	Method
Otoacoustic emissions	through study completion, an average of 1 year	Measure of inner ear function
Fidgeting	through study completion, an average of 1 year	Measure of wrist movements during the testing
NIH Toolbox Cognition testing	through study completion, an average of 1 year	Measures of cognitive functions
Sensory profile questionnaire	through study completion, an average of 1 year	Sensory processing assessment
Tympanogram	through study completion, an average of 1 year	Results of tympanometry (type, volume, pressure, compliance, gradient) to measure middle ear function
Hearing screening	through study completion, an average of 1 year	Pure-tone hearing test to measure hearing sensitivity

Locations (1): Nemours Children's Health
🇺🇸
Wilmington, Delaware, United States