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ADHD study puts money where the brain is

MIND Institute uses prizes to get - and measure - subjects' attention

Published: Sunday, Dec. 14, 2008 - 12:00 am | Page 5L

You know the type. Heck, you may even be the type.

You flit from task to uncompleted task, losing interest based on how hard and boring it becomes. You choose the task of least resistance and focus on immediate gains, not richer, more long-term rewards.

So who are you?

"Around tax time," says UC Davis MIND Institute researcher Julie Schweitzer, "that's everybody. That's when cleaning the toilet suddenly becomes really interesting."

But for people with ADHD – attention deficit hyperactivity disorder – such distractedness is not mere procrastination. Though the hyperactive aspects of the condition are most obvious, inattention arguably can be more debilitating – especially for adults.

Schweitzer, an associate professor in UC Davis' department of psychiatry and behavioral sciences, is spearheading a study to determine what chemical functions in the brain trigger an ADHD person's compulsion to abandon tasks and exhibit "exploratory" behavior.

The study is zeroing in on a neurohormone called norepinephrine, which affects the part of the brain (the locus coreruleus) where attention is controlled. If the study backs Schweitzer's hypothesis – that if the norepinephrine can be regulated pharmacologically or behaviorally, it could help keep people on task – it could have significant implications in ADHD treatment.

Norepinephrine is far less known and less studied than dopamine, its fellow ADHD-intensive chemical. Firing rates for norepinephrine could explain why you ditch paying the bills halfway through to floss your teeth or rearrange your sock drawer.

The link between decision-making and neurochemistry is not entirely new, Schweitzer concedes, but it's been almost entirely focused on dopamine, the so-called "pleasure" hormone.

Studies centering on norepinephrine and task-to-reward difficulty have been conducted only on primates. And one such study on monkeys determined that measurement of pupil size of subjects can determine norepinephrine levels, meaning costly and invasive brain imaging is not needed.

How Schweitzer and colleagues are testing the relationship between task difficulty and fluctuating hormone levels in human subjects is noninvasive and, well, kind of fun.

It amounts to sort of a computer-driven game show, complete with valuable cash prizes.

Subjects are given the task of listening to two tones and must determine which is louder. As the test goes on, the distinctions between the tones get more difficult to decipher. Each correct answer gives the subject more prize money.

"At some point," Schweitzer says, "you have to decide how much time and energy you're going to invest in something, and whether there's another path that might pay less but that's easier to get something out of."

It's at that crucial point where a subject decided to either "accept" a harder question or "escape" to an easier one where the pupil size (and, by proxy, norepinephrine levels) is measured.

(An eye-tracking system built directly into the computer makes sure a subject keeps looking at the screen so that pupil levels can be charted 30 times a second.)

Schweitzer, by the way, won't say exactly how much money subjects – both those with ADHD and a control group – are paid, but she says it's worth their while.

Hey, who says brain studies have to be boring? That is, unless you're studying boredom. Which is partially what this research is doing.

Schweitzer has given her study a pop-culture twist, too, calling it "Should I Stay or Should I Go," a nod to the Clash's 1982 hit. "We're all susceptible to things on the periphery," she says. "But for people with ADHD, this is very problematic. I've talked with lots of adults sitting at their desks, and they see something that distracts them and go off and do that and never get back to the (original task). Lots of sales people with ADHD loved going from place to place with their job, but when they're promoted and put behind a desk, they hate it and often fail."

Schweitzer sees norepinephrine uptake inhibitors working in tandem with existing ADHD medications that regulate dopamine levels. In May, the Food and Drug Administration approved a new drug for ADHD use, Strattera, which affects only norepinephrine levels.

"Potentially," Schweitzer says, "I think you will subtype the kinds of ADHD in children and adults according to the norepinephrine bursts vs. the dopamine. Then we'd have a better idea about the intervention that is most appropriate."


Call The Bee's Sam McManis, (916) 321-1145.


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