Predicting adult Attention Deficit Hyperactivity Disorder (ADHD) using vocal acoustic features

medRxiv

Abstract

Abstract Background It is a key concern in psychiatric research to investigate objective measures to support and ultimately improve diagnostic processes. Current gold standard diagnostic procedures for attention deficit hyperactivity disorder (ADHD) are mainly subjective and prone to bias. Objective measures such as neuropsychological measures and EEG markers show limited specificity. Recent studies point to alterations of voice and speech production to reflect psychiatric symptoms also related to ADHD. However, studies investigating voice in large clinical samples allowing for individual-level prediction of ADHD are lacking. The aim of this study was to explore a role of prosodic voice measures as objective marker of ADHD. Methods 1005 recordings were analyzed from 387 ADHD patients, 204 healthy controls, and 100 clinical (psychiatric) controls. All participants (age range 18-59 years, mean age 34.4) underwent an extensive diagnostic examination according to gold standard methods and provided speech samples (3 min in total) including free and given speech. Paralinguistic features were calculated, and random forest based classifications were performed using a 10-fold cross-validation with 100 repetitions controlling for age, sex, and education. Association of voice features and ADHD-symptom severity assessed in the clinical interview were analyzed using random forest regressions. Results and Conclusion ADHD was predicted with AUC = 0.76. The analysis of a non-comorbid sample of ADHD resulted in similar classification performance. Paralinguistic features were associated with ADHD-symptom severity as indicated by random forest regression. In female participants, particularly with age < 32 years, paralinguistic features showed the highest classification performance (AUC = 0.86). Paralinguistic features based on derivatives of loudness and fundamental frequency seem to be promising candidates for further research into vocal acoustic biomarkers of ADHD. Given the relatively good performance in female participants independent of comorbidity, vocal measures may evolve as a clinically supportive option in the complex diagnostic process in this patient group.

Authors 8

1. Georg G. von Polier corresponding Aachen

   Forschungszentrum Jülich · University Hospital Frankfurt · RWTH Aachen University

   Affiliation as printed

   Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; RWTH Aachen University, Aachen, Germany

   Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; University Hospital Frankfurt, Frankfurt, Germany

   Institute of Neuroscience and Medicine Brain and Behaviour; Forschungszentrum Jülich; Jülich, Germany

   Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy

   Forschungszentrum Jülich

   Institute of Neuroscience and Medicine Brain and Behaviour

   RWTH Aachen University, Aachen, Germany

   University Hospital Frankfurt, Frankfurt, Germany

2. Eike Ahlers

   Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

   Affiliation as printed

   Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Psychiatry Campus Benjamin Franklin, Berlin, Germany

3. Julia Amunts

   Forschungszentrum Jülich

   Affiliation as printed

   Institute of Neuroscience and Medicine Brain and Behaviour; Forschungszentrum Jülich; Jülich, Germany

   Forschungszentrum Jülich

   Institute of Neuroscience and Medicine Brain and Behaviour

   Jülich, Germany

4. Jörg Langner
   Affiliation as printed

   Peak Profiling GmbH, Berlin, Germany

5. Kaustubh R. Patil

   Forschungszentrum Jülich · Heinrich Heine University Düsseldorf

   Affiliation as printed

   Institute of Neuroscience and Medicine Brain and Behaviour; Forschungszentrum Jülich; Jülich, Germany

   Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

   Forschungszentrum Jülich

   Institute of Neuroscience and Medicine Brain and Behaviour

   Jülich, Germany

6. Simon Bodo Eickhoff

   Forschungszentrum Jülich · Heinrich Heine University Düsseldorf

   Affiliation as printed

   Institute of Neuroscience and Medicine Brain and Behaviour; Forschungszentrum Jülich; Jülich, Germany

   Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

   Forschungszentrum Jülich

   Institute of Neuroscience and Medicine Brain and Behaviour

   Jülich, Germany

7. Florian Helmhold

   University of Tübingen

   Affiliation as printed

   Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany

8. Daina Langner

   Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

   Affiliation as printed

   Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Psychiatry Campus Benjamin Franklin, Berlin, Germany