Method for determining fluctuation in attentional state and overall attentional state

• US 6,685,652 B1
• Filed: 05/17/2001
• Issued: 02/03/2004
• Est. Priority Date: 05/17/2000
• Status: Expired due to Term

• Current Assignee: Mclean Hospital (Mass General Brigham, Inc.)
• Original Assignee: Mclean Hospital (Mass General Brigham, Inc.)
• Inventors: Teicher, Martin H., Lowen, Steven B.
• Primary Examiner(s): Winakur, Eric F.
• Assistant Examiner(s): McCrosky, David J.
• Application Number:
  US09/860,701
• Time in Patent Office: 992 Days
• Field of Search: 600/587-595, 600/558, 600/300, 600/559, 434/236
• US Class Current: 600/558
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/168 Evaluating attention deficit, hyperactivity

Abstract

The invention provides methods for determining shifts in the attentional state of a subject. These methods are useful for diagnosing subjects with a psychological or behavioral disorder. The invention also features methods for determining the effect of a therapy on the overall attentional state and shifts in the attentional state of a subject.

Claims

1. A method of acquiring information about the pattern or fluctuation in attentional state of a subject, said method comprising:

(a) presenting to said subject a sequence comprising target and nontarget stimuli, wherein said sequence is divided into three or more epochs in which there are a predetermined number of target and nontarget stimuli over a predetermined period of time;

(b) scoring the response of said subject on the percentage of targets responded to and the percentage of nontargets responded to during each epoch; and

(c) on the basis of the scoring of step (b), making a determination of the attentional state of said subject during each epoch;

whereby the pattern or fluxuation in attentional states during the test period is assessed.

2. The method of claim 1, wherein the determination of step (c) comprises assessing both overall attention and impulsivity.

3. The method of claim 2, wherein steps (a) and (b) are repeated three or more times, whereby the pattern of attentional states and the length of time spent in each state is assessed.

4. The method of claim 1, wherein said stimuli are visual symbols.

5. The method of claim 4, wherein said visual symbols comprise individual numbers, letters, or shapes, or a combination thereof.

6. The method of claim 1, wherein said stimuli are audio sounds.

7. The method of claim 1, wherein said method is used to diagnose a neurological, psychological, or behavioral disorder.

8. The method of claim 7, wherein said disorder is depression, an anxiety disorder, schizophrenia, drug addiction, an eating disorder, attention deficit disorder, attention deficit hyperactivity disorder, a learning disorder, Alzheimer'"'"'s disease, dementia, epilepsy, stroke or traumatic brain injury.

9. The method of claim 1, further comprising:

(d) comparing the determination of step (c) in subjects diagnosed with a disorder and subjects not diagnosed with said disorder.

10. The method of claim 1, wherein said subject is involved in a clinical trial of a therapy for a psychological, neurological, or behavioral disorder.

11. The method of claim 1, wherein said method is used to determine the preferred therapy for the treatment of a psychological, neurological, or behavioral disorder.

12. The method claim 1, wherein said stimuli are presented using a computer screen or speaker and each subject'"'"'s responses are stored in a computer.

13. The method of claim 1, wherein said subject communicates with a test administrator across a network.

14. The method of claim 1, wherein the results of said method are used in determining the eligibility of said subject to obtain a driver'"'"'s license.

15. The method of claim 1, wherein the method is used to evaluate the subjects suitability for a position as an air traffic controller, pilot, emergency room doctor surgeons, police officer, military officer, or fire-fighter.

16. The method of claim 1, wherein the method is used to evaluate readiness of a subject to start school or to be promoted to the next grade or level.

17. The method of claim 1, wherein the number of stimuli is 15 or greater.

18. The method of claim 1, wherein said epochs are the same length.

19. A method of determining whether a therapy affects the attentional state of a subject, said method comprising:

(a) presenting to said subject undergoing treatment with said therapy a sequence comprising target and nontarget stimuli, wherein said sequence is divided into three or more epochs in which there are a predetermined number of target and nontarget stimuli over a predetermined period of time;

(b) scoring the response of said subject on the percentage of targets responded to and the percentage of nontargets responded to during each epoch; and

(c) on the basis of the scoring of step (b), making a determination of the attentional state of said subject during each epoch;

whereby the pattern in attentional states during the test period is assessed, wherein an altered pattern of attentional states, compared to either the pattern of attentional states of said subject when not undergoing treatment with said therapy, or the pattern of attentional states of a control subject when not undergoing treatment with said therapy, indicates that said therapy affects the pattern of attentional states of said subject.

20. The method of claim 19, wherein the determination of step (b) comprises assessing both overall attention and impulsivity.

21. The method of claim 20, wherein steps (a) and (b) are repeated three or more times, whereby the pattern of attentional states and the length of time spent in each state is assessed.

22. The method of claim 19, further comprising:

(d) comparing the effect of said therapy on the attentional state of said subject to the effect of another therapy on the attentional state of said subject.

23. The method of claim 19, wherein said stimuli are visual symbols.

24. The method of claim 19, wherein said visual symbols comprise individual numbers, letters, or shapes, or a combination thereof.

25. The method of claim 19, wherein said stimuli are audio sounds.

26. The method of claim 19, wherein said subject is diagnosed with a neurological, psychological, or behavioral disorder.

27. The method of claim 26, wherein said disorder is depression, an anxiety disorder, schizophrenia, drug addiction, an eating disorder, attention deficit disorder, attention deficit hyperactivity disorder, a learning disorder, Alzheimer'"'"'s disease, dementia, epilepsy, stroke or traumatic brain injury.

28. The method of claim 19, further comprising:

(d) comparing the determination of step (c) in subjects diagnosed with a disorder and subjects not diagnosed with said disorder.

29. The method of claim 19, wherein said subject is involved in a clinical trial of a therapy for a psychological, neurological, or behavioral disorder.

30. The method of claim 19, wherein said method is used to determine the preferred therapy for the treatment of a psychological, neurological, or behavioral disorder.

31. The method claim 19, wherein said stimuli are presented using a computer screen or speaker and each subject'"'"'s responses are stored in a computer.

32. The method of claim 19, wherein said subject communicates with a test administrator across a network.

33. The method of claim 19, wherein the number of stimuli is 15 or greater.

34. The method of claim 19, wherein said epochs are the same length.

35. A method of acquiring information about the attentional state of a subject, said method comprising:

(a) presenting to said subject a sequence comprising target and nontarget stimuli, wherein said sequence is divided into three or more epochs in which there are a predetermined number of target and nontarget stimuli over a predetermined period of time;

(b) scoring the response of said subject on the percentage of targets responded to and the percentage of nontargets responded to during each epoch; and

(c) on the basis of the scoring of step (b), making a determination of the attentional state of said subject during each epoch;

whereby the length of time spent in a particular attentional state during the test period is assessed.

36. The method of claim 35, wherein said epochs are the same length.

37. A method of determining whether a therapy affects the attentional state of a subject, said method comprising:

(a) presenting to said subject undergoing treatment with said therapy a sequence comprising target and nontarget stimuli, wherein said sequence is divided into three or more epochs in which there are a predetermined number of target and nontarget stimuli over a predetermined period of time;

(b) scoring the response of said subject on the percentage of targets responded to and the percentage of nontargets responded to during each epoch; and

(c) on the basis of the scoring of step (b), making a determination of the attentional state of said subject during each epoch;

whereby the length of time spent in a particular attentional state during the test period is assessed, wherein an length of time spent in a particular attentional state, compared to either the length of time spent in a particular attentional state of said subject when not undergoing treatment with said therapy or the length of time spent in a particular attentional state of a control subject when not undergoing treatment with said therapy, indicates that said therapy affects the length of time spent in a particular attentional state of said subject.

38. The method of claim 37, wherein said epochs are the same length.

39. A method of acquiring information about the attentional state of a subject, said method comprising:

(a) presenting to said subject a sequence of a predetermined number of stimuli over a predetermined period of time, wherein said sequence comprises target and nontarget stimuli;

(b) scoring the response of said subject on the percentage of targets responded to (T) and the percentage of nontargets responded to (N); and

(c) on the basis of the scoring of step (b), making a determination of the attentional state of said subject, wherein said attentional state is selected from the group consisting of;

a first attentional state characterized by N and T differing by less than 25% and said subject responding to more than half of the stimuli;

a second attentional state characterized by N and T differing by less than 25% and said subject responding to less than half of the stimuli;

a third attentional state characterized by T being 85% or greater and N being 20% or less;

a fourth attentional state characterized by T being 85% or greater and N exceeding 20%;

a fifth attentional state characterized by T being less than 85%, T being greater than N, and said subject not being in said first or second attentional state; and

a sixth attentional state characterized by N exceeding T by more than 25%.

40. A method of determining whether a therapy affects the attentional state of a subject, said method comprising:

(a) presenting to said subject undergoing treatment with said therapy a sequence of a predetermined number of stimuli over a predetermined period of time, wherein said sequence comprises target and nontarget stimuli;

(b) scoring the response of said subject on the percentage of targets responded to (T) and the percentage of nontargets responded to (N); and

(c) on the basis of the scoring of step (b), making a determination of the attentional state of said subject, wherein said attentional state is selected from the group consisting of;

a first attentional state characterized by N and T differing by less than 25% and said subject responding to more than half of the stimuli;

a second attentional state characterized by N and T differing by less than 25% and said subject responding to less than half of the stimuli;

a third attentional state characterized by T being 85% or greater and N being 20% or less;

a fourth attentional state characterized by T being 85% or greater and N exceeding 20%;

a fifth attentional state characterized by T being less than 85%, T being greater than N, and said subject not being in said first or second attentional state; and

a sixth attentional state characterized by N exceeding T by more than 25%; and

wherein an altered attentional state, compared to either the attentional state of said subject when not undergoing treatment with said therapy or the attentional state of a control subject when not undergoing treatment with said therapy, indicates that said therapy affects the attentional state of said subject.