Surgery – Diagnostic testing
Reexamination Certificate
2001-05-25
2003-11-25
Winakur, Eric F. (Department: 3736)
Surgery
Diagnostic testing
C600S595000, C351S210000
Reexamination Certificate
active
06652458
ABSTRACT:
FIELD OF THE INVENTION
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
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.
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).
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:
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.
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).
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).
4. U.S. Pat. No. 6,097,980, issued Aug. 1, 2000, inventor Monastra et al, discloses a quantitative electroencephalographic process assessing ADHD.
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.
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.
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.
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.
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.
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.
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.
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.
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 V5 #105 5 May 2000). In some cases those individuals who meet DSM-IV criteria for ADHD diagnosis are prescribed a drug such as RITALIN (methylphenidate). Behavioral observations of the patient while on RITALIN are conducted to assess the impact of prescribed medication.
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's physiologic changes and accordingly uses different protocols.
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
According to the present invention, there is provided a solution to the problems and fulfillment of the needs discussed above.
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
The invention has the following advantages.
1. A technique for diagnosing ADHD is provided which is simple, inexpensive and reliable.
REFERENCES:
patent: 4456347 (1984-06-01), Stahly
patent: 4889422 (1989-12-01), Pavlidis
patent: 5377100 (1994-12-01), Pope et al.
patent: 5913310 (1999-06-01), Brown
patent: 5918603 (1999-07-01), Brown
patent: 5940801 (1999-08-01), Brown
patent: 6053739 (2000-04-01), Stewart et al.
patent: 6097980 (2000-08-01), Monastra et al.
patent: 6117075 (2000-09-01), Barnea
patent: 6231187 (2001-05-01), Munoz et al.
Munoz, D.P. et al, Control of Purposive Saccadic Eye Movements and Visual Fixation in Children with Attention-Deficit Hyperactivity Disorder, 1999, Plenum Publishing, Current Oculomotor Research: Physiological and Psychological Aspects pp. 1-9.*
Munoz, D.P. et al, Attentional and Psychiatric Influences on Gaze, 1997, North American Neuro-ophthalmology Society, pp. 237-240.*
Disclosure on the Development of EEG Diagnostics and Biofeedback for Attention-Deficit/Hyperactivity Disorders, Joel F. Lubar, Biofeedback and Self-Regulation, vol. 6, No. 3, 191.
Functional Deficits in Basal Ganglia of Children with Attention-Deficit/Hyperactivity Disorder Shown with Functional Magnetic Resonance Imaging Relaxometry, Teichler et al., Nature Magazine, Apr. 2000, vol. 6, No. 4, pp 470-473.
Human Factors and Cognitive/Perceptual Information Processing, A virtuality Reality Environment for the Assessment of Attention Deficit Disorders in Children, Rizzo et al., Human Factors and Cognitive/Perceptual information Processing, University of Southern California, Jul. 1999.
Clinical Practice Guideline: Diagnosis and Evaluation of the Child with Attention-Deficit/Hyperactivity Disorder, Homer et al., American Academy of Pediatrics.
Blazey Richard N.
Parks Peter A.
Patton David L.
Clark Paul T.
Clark & Elbing LLP
McCrosky David J.
The McLean Hospital Corporation
Winakur Eric F.
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