ArticleFrontiers in cognition2026
Temporal variability in pupillary asymmetry reflects ADHD-related traits in preschool and early school-aged children.
Article in Frontiers in cognition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Attention-deficit/hyperactivity disorder (ADHD) often emerges in early childhood; however, objective validated biomarkers for its early detection remain limited. In this study, we aimed to identify pupil-based candidate physiological markers (i.e., physiological correlates) associated with ADHD-related traits in preschool- and early school-aged children. To this end, we recorded the pupil diameters of typically developing children without an ADHD diagnosis during a simple fixation task. From these data, we extracted multiple features, including the mean pupil size, temporal variability, and interocular asymmetry in both magnitude and variability. ADHD-related tendencies were assessed using the ADHD Rating Scale-5. Among the features analyzed, only the temporal variability of interocular asymmetry (VarLRdiff) showed a significant positive correlation with ADHD Rating Scale-5 total and subscale scores. This association likely reflects the combined effects of immature autonomic regulation and functional asymmetry in the neural circuits involving the locus coeruleus. In contrast, other pupil-based indices showed no significant correlations, potentially because of developmental ceiling effects and the short evaluation duration. These findings suggest that VarLRdiff may serve as a promising candidate physiological marker of ADHD-related traits in young children, requiring further validation. Future studies incorporating longer recordings, advanced analytical methods, and evaluation of test-retest stability, as well as longitudinal follow-up, are warranted to evaluate its potential utility for early screening, pending clinical and longitudinal validation.
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