Technique for diagnosing attention deficit hyperactivity disorder using complimentary tests

• US 6,746,409 B2
• Filed: 02/14/2002
• Issued: 06/08/2004
• Est. Priority Date: 02/14/2002
• Status: Expired due to Fees

• Current Assignee: Mclean Hospital (Mass General Brigham, Inc.)
• Original Assignee: Mclean Hospital (Mass General Brigham, Inc.)
• Inventors: Patton, David L., Keirsbilck, Richard S., Parks, Peter A., Miller, Paige, Blazey, Richard N.
• Primary Examiner(s): MARMOR II, CHARLES ALAN
• Application Number:
  US10/076,261
• Publication Number:
  US 20030158496A1
• Time in Patent Office: 845 Days
• Field of Search: 600/26-28, 600/300, 600/301, 600/481, 600/500, 600/509, 600/544, 600/546, 600/549, 128/897, 128/898
• US Class Current: 600/549
• CPC Class Codes: A61B 5/168 Evaluating attention deficit, hyperactivity
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61B 5/726 using Wavelet transforms

Abstract

A method of determining threshold values, subsequently used to determine whether an individual has Attention Deficit Hyperactivity Disorder (ADHD) comprising: providing a group of subjects, a segment of which is known to have ADHD and a segment is known to not have ADHD; and testing each subject in the group by: (a) sampling the peripheral skin temperature of left and right like extremities during a predetermined time interval when the subject is in a sensory deprived state to provide respective left and right sampled peripheral skin temperature data; (b) processing the sampled peripheral skin temperature data, including filtering, differentiation, and conversion to the frequency domain to derive spectral signatures having magnitude values; and (c) final processing of spectral signatures for all of the subjects of the group to determine threshold values which are complimentarily effective for determining whether or not an individual has ADHD when tested by the testing method.

Claims

1. A method for determining two threshold values used to determine whether an individual has Attention Deficit Hyperactivity Disorder (ADHD) comprising:

providing a group of subjects a segment of which is known to have ADHD and a segment of which is known to be normal and not have ADHD;

testing the group by;

(a) sampling the peripheral skin temperature of left and right like extremities of each subject in the group during a predetermined time interval when they are in a sensory deprived state to provide respective left and right sampled peripheral skin temperature data;

(b) a first processing of at least one of said left and right sampled peripheral skin temperature data providing conversion to the frequency domain to derive a first spectral signature having magnitude values;

(c) a second processing of both left and right sampled peripheral skin temperature data to derive temporally correlated differential data;

(d) said second processing further filtering said differential data with a high pass filter to produce filtered differential data with near d.c. components removed;

(e) said second processing lastly providing conversion to the frequency domain of said filtered differential data to derive a second spectral signature having magnitude values; and

(f) a third processing of said first and second spectral signatures for all of the subjects of the group to determine respective first and second threshold values which are complimentarily effective for determining whether or not an individual has ADHD when tested by said testing method.

2. The method of claim 1 wherein said left and right extremities sampled are the pair of said subject'"'"'s two hands or two feet.

3. The method of claim 2 wherein one or more digits of each of said pair are sampled during said sampling.

4. The method of claim 1 wherein said left and right extremities sampled are said subject'"'"'s ears.

5. The method of claim 1 wherein said differential data is derived by subtracting one of said left and right sampled data from the other of said left and right sampled data.

6. The method of claim 1 wherein said high pass filter is a Butterworth Highpass Infinite Impulse Response Filter.

7. The method of claim 1 wherein said second spectral signature has a spectral response of interest which is centered around approximately 0.03 Hz.

8. The method of claim 1 wherein said third processing uses discriminant analysis to determine said first threshold value.

9. The method of claim 1 wherein said third processing uses descriminant analysis to determine said second threshold value.

10. The method of claim 1 wherein said third processing uses a selected percent of correct diagnoses to determine said first threshold value.

11. The method of claim 1 wherein said third processing uses a selected percent of correct diagnoses to determine said second threshold value.

12. The method of claim 1 wherein said third processing uses a selected weighted percent of false positive and/or false negative diagnoses to determine said first threshold value.

13. The method of claim 1 wherein said third processing uses a selected weighted percent of false positive and/or false negative diagnoses to determine said second threshold value.

14. The method of claim 1 wherein said group of subjects provided include individuals of both male and female gender in each segment;

and

wherein acceptable threshold values are determined for each of said genders.

15. The method of claim 1 wherein said group of subjects provided include individuals in at least two different age groups in each segment;

and

wherein acceptable threshold values are determined for each of said different age groups.

16. The method of claim 1 wherein during said testing, one or more of the following causes of noise are minimized:

self diversion, ambient visual and auditory stimulation, technical problems, sleep problems, and medication problems.

17. The method of claim 1 including providing headphones adapted to be worn by said subjects during said predetermined time interval to block out ambient noise or to receive white noise to reduce or eliminate auditory stimulus from the ambient environment during said predetermined time interval.

18. The method of claim 17 including a source of white noise coupled to said headphones to provide white noise during said predetermined time interval.

19. The method of claim 1 including providing glasses or goggles adapted to be worn by the subject to block out or eliminate visual stimulus from the ambient environment during said predetermined time interval.

20. The method of claim 19 including presenting a uniformly illuminated visual field to said subjects during said predetermined time interval to minimize the human propensity to self-stimulate with mental imagery.

21. A method of determining whether an individual has Attention Deficit Hyperactivity Disorder, comprising:

testing the individual by;

(a) sampling the peripheral skin temperatures of left and right like extremities of the individual during a predetermined time interval when the individual is in a sensory deprived state to provide respective left and right sampled peripheral skin temperature data;

(b) a first processing of at least one of said left and right sampled peripheral skin temperature data providing conversion to the frequency domain to derive a first spectral signature having magnitude values;

(c) a second processing of both left and right sampled peripheral skin temperature data to derive temporally correlated differential data;

(d) said second processing further filtering said differential data with a high pass filter to produce filtered differential data with near d.c. components removed;

(e) said second processing lastly providing conversion to the frequency domain of said filtered differential data to derive a second spectral signature having magnitude values;

(f) a third processing of the said first spectral signature for the determination of the manifestation of ADHD by comparison to a predetermined first threshold value;

(g) a fourth processing of the said second spectral signature for the determination of the manifestation of ADHD by comparison to a predetermined second threshold value;

wherein said predetermined first and second threshold values are determined by the method of claim 1; and

(h) a fifth processing wherein an assessment of the bi-modal quality of the results of the third and fourth processing is made, to provide a final determination of one of three possibilities;

(1) the thusly-tested individual has ADHD;

(2) the thusly-tested individual does not have ADHD; and

(3) there is noise in the data.

22. The method of claim 21 wherein said left and right extremities sampled are the pair of said individuals two hands or two feet.

23. The method of claim 22 wherein one or more digits of each of said pair are sampled during said sampling.

24. The method of claim 21 wherein said left and right extremities sampled are said individual'"'"'s ears.

25. The method of claim 21 wherein said differential data is derived by subtracting one of said left and right sampled data from the other of said left and right sampled data.

26. The method of claim 21 wherein said high pass filter is a Butterworth Highpass Infinite Impulse Response Filter.

27. The method of claim 21 wherein said second spectral signature has a spectral response of interest which is centered around approximately 0.03 Hz.

28. The method of claim 21 wherein different threshold values are used for each of both genders.

29. The method of claim 21 wherein different threshold values are used for each of different age groups.

30. The method of claim 21 wherein during said testing, one or more of the following causes of noise are minimized:

self diversion, ambient visual and auditory stimulation, technical problems, sleep problems, and medication problems.

31. The method of claim 21 including providing headphones adapted to be worn by the individual during said predetermined time interval to block out ambient noise or to receive white noise to reduce or eliminate auditory stimulus from the ambient environment during said predetermined time interval.

32. The method of claim 31 including providing a source of white noise coupled to said headphones to provide white noise during said predetermined time interval.

33. The method of claim 21 including providing glasses or goggles adapted to be worn by the individual to block out or eliminate visual stimulus from the ambient environment during said predetermined time interval.

34. The method of claim 33 including presenting a uniformly illuminated visual field to the individual during said predetermined time interval to minimize the human propensity to self-stimulate with mental imagery.

35. The method of claim 21 wherein said fifth processing assessment requires that both:

(a) said first spectral signature has a magnitude less than said first threshold value, and

(b) said second spectral signature has a magnitude greater than said second threshold value, in order for a diagnosis of ADHD to be made.

36. The method of claim 21 wherein said fifth processing assessment requires that both:

(a) said first spectral signature has a magnitude greater than said first threshold value, and

(b) said second spectral signature has a magnitude less than said second threshold value, in order for a diagnosis of non-ADHD to be made.

37. The method of claim 21 wherein said fifth processing assessment provides that obtaining only one of two requirements:

(a) said first spectral signature has a magnitude less than said first threshold value, and

(b) said second spectral signature has a magnitude greater than said second threshold value, determines the presence of noise in the data, thereby invalidating said data.

38. The method of claim 21 wherein said fifth processing assessment provides that obtaining only one of two requirements:

(a) said first spectral signature has a magnitude greater than said first threshold value; and

(b) said second spectral signature has a magnitude less than said second threshold value, determines the presence of noise in the data, thereby invalidating said data.