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Roording-Ragetlie SL, Pieters S, Wennekers E, Klip H, Buitelaar J, Slaats-Willemse D. Working memory training in children with neurodevelopmental disorders and intellectual disabilities, the role of coaching: A double-blind randomised controlled trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:842-859. [PMID: 37313626 DOI: 10.1111/jir.13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Working memory training (WMT) can offer therapeutic benefits to patients with neurodevelopmental disorders (NDD) and mild to borderline intellectual disability (MBID). However, consistent evidence for treatment benefits of WMT over placebo training is missing. So far, participants in double-blind research designs did receive non-specific coaching, whereas active coaching based on individual training results might increase the efficacy of WMT. Furthermore, the intensity and duration of WMT is often too stressful for these children. This study therefore investigated whether a less intensive but more prolonged WMT, with active personalised coaching and feedback, would reduce behavioural symptoms and improve neurocognitive functioning and academic achievements in children with NDD and MBID. METHOD A double-blind randomised controlled trial in children (aged 10;0-13;11) with MBID (60 < IQ < 85) and ADHD and/or ASD evaluated the effects of a less intensive but prolonged version of the original Cogmed WMT (30 min a day, 4 days a week, 8 weeks in total). Eighteen participants received active, personalised coaching and feedback, based on their actual individual performance during training. Twenty-two received general non-personalised coaching for the same amount of time. Executive functioning, academic achievements and several behavioural measurements were administered, before and after training, with a 6-months follow-up. RESULTS We observed a significant effect of time on both primary and secondary outcome measures, indicating that all children improved in working memory performance and other neurocognitive and academic outcomes. The interaction between time and group was not significant. DISCUSSION This study was unable to document superior effects of active personalised coaching and feedback compared with general non-personalised coaching and no feedback in an adaptive WMT in children with MBID and NDD. The objectively documented changes over time suggest that for these vulnerable children, a regular, structured and structural contact with a coach and adapted exercises is enough to develop therapy fidelity, boost motivation and improve neurodevelopmental task performance. Further research is needed to examine which possible subgroups within this heterogenic group of children profit more from WMT compared with other subgroups.
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Affiliation(s)
| | - S Pieters
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
- Radboud University, Behavioural Science Institute, Nijmegen, The Netherlands
| | - E Wennekers
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
| | - H Klip
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
| | - J Buitelaar
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - D Slaats-Willemse
- Department of Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Denkkracht, Center for Neuropsychological Expertise, Nijmegen-Arnhem, The Netherlands
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Tullo D, Feng Y, Pahor A, Cote JM, Seitz AR, Jaeggi SM. Investigating the Role of Individual Differences in Adherence to Cognitive Training. J Cogn 2023; 6:48. [PMID: 37636013 PMCID: PMC10453960 DOI: 10.5334/joc.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Consistent with research across several domains, intervention adherence is associated with desired outcomes. Our study investigates adherence, defined by participants' commitment to, persistence with, and compliance with an intervention's regimen, as a key mechanism underlying cognitive training effectiveness. We examine this relationship in a large and diverse sample comprising 4,775 adults between the ages of 18 and 93. We test the predictive validity of individual difference factors, such as age, gender, cognitive capability (i.e., fluid reasoning and working memory), grit, ambition, personality, self-perceived cognitive failures, socioeconomic status, exercise, and education on commitment to and persistence with a 20-session cognitive training regimen, as measured by the number of sessions completed. Additionally, we test the relationship between compliance measures: (i) spacing between training sessions, as measured by the average time between training sessions, and (ii) consistency in the training schedule, as measured by the variance in time between training sessions, with performance trajectories on the training task. Our data suggest that none of these factors reliably predict commitment to, persistence with, or compliance with cognitive training. Nevertheless, the lack of evidence from the large and representative sample extends the knowledge from previous research exploring limited, heterogenous samples, characterized by older adult populations. The absence of reliable predictors for commitment, persistence, and compliance in cognitive training suggests that nomothetic factors may affect program adherence. Future research will be well served to examine diverse approaches to increasing motivation in cognitive training to improve program evaluation and reconcile the inconsistency in findings across the field.
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Affiliation(s)
| | - Yi Feng
- University of California Irvine, Irvine, USA
| | - Anja Pahor
- Univerza v Mariboru, Maribor, Slovenia
- Northeastern University, Boston, USA
- University of California Riverside, Riverside, USA
| | | | - Aaron R. Seitz
- Northeastern University, Boston, USA
- University of California Riverside, Riverside, USA
| | - Susanne M. Jaeggi
- University of California Irvine, Irvine, USA
- Northeastern University, Boston, USA
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Robledo-Castro C, Castillo-Ossa LF, Corchado JM. Artificial Cognitive Systems Applied in Executive Function Stimulation and Rehabilitation Programs: A Systematic Review. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2022; 48:2399-2427. [PMID: 36185593 PMCID: PMC9516512 DOI: 10.1007/s13369-022-07292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/11/2022]
Abstract
This article presents a systematic review of studies on cognitive training programs based on artificial cognitive systems and digital technologies and their effect on executive functions. The aim has been to identify which populations have been studied, the characteristics of the implemented programs, the types of implemented cognitive systems and digital technologies, the evaluated executive functions, and the key findings of these studies. The review has been carried out following the PRISMA protocol; five databases have been selected from which 1889 records were extracted. The articles were filtered following established criteria, to give a final selection of 264 articles that have been used for the purposes of this study in the analysis phase. The findings showed that the most studied populations were school-age children and the elderly. The most studied executive functions were working memory and attentional processes, followed by inhibitory control and processing speed. Many programs were commercial, customizable, gamified, and based on classic tasks. Some more recent initiatives have begun to incorporate user-machine interfaces, robotics, and virtual reality, although studies on their effects remain scarce. The studies recognize multiple benefits of computerized neuropsychological stimulation and rehabilitation programs for executive functions in different age groups, but there is a lack of studies in specific population sectors and with more rigorous research designs. Supplementary Information The online version contains supplementary material available at 10.1007/s13369-022-07292-5.
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Affiliation(s)
- Carolina Robledo-Castro
- Currículo, Universidad y Sociedad Research Group, Universidad del Tolima, Calle 42 1-02, 730006299 Ibagué, Colombia
- Ingeniería del Software Research Group, Universidad Autónoma de Manizales, Antigua Estación del Ferrocarril, 170001 Manizales, Colombia
| | - Luis F. Castillo-Ossa
- Ingeniería del Software Research Group, Universidad Autónoma de Manizales, Antigua Estación del Ferrocarril, 170001 Manizales, Colombia
- Inteligencia Artificial Research Group, Universidad de Caldas, Calle 65 26-10, 170002 Manizales, Colombia
- Departamento de Ingeniería Indutrial, Universidad Nacional de Colombia Sede Manizales, Campus La Nubia, 170001 Manizales, Colombia
| | - Juan M. Corchado
- BISITE Research Group, University of Salamanca, Calle Espejo s/n, 37007 Salamanca, Spain
- Air Institute, IoT Digital Innovation Hub, 37188 Salamanca, Spain
- Department of Electronics, Information and Communication, Osaka Institute of Technology, 535-8585 Osaka, Japan
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Quintero J, Gutiérrez-Casares JR, Álamo C. Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review. Neurol Ther 2022; 11:1489-1517. [PMID: 35951288 DOI: 10.1007/s40120-022-00392-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/28/2022] [Indexed: 10/15/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common childhood-onset neurodevelopmental disorder characterised by persistent inattention, hyperactivity and impulsivity. Moreover, ADHD is commonly associated with other comorbid diseases (depression, anxiety, bipolar disorder, etc.). The ADHD symptomatology interferes with subject function and development. The treatment of ADHD requires a multidisciplinary approach based on a combination of non-pharmacological and pharmacological treatments with the aim of ameliorating the symptomatology; among first-line pharmacological treatments are stimulants [such as methylphenidate (MPH) and lisdexamfetamine dimesylate (LDX)]. In this review we explored recent ADHD- and stimulants-related literature, with the aim of compiling available descriptions of molecular pathways altered in ADHD, and molecular mechanisms of current first-line stimulants MPH and LDX. While conducting the narrative review, we applied structured search strategies covering PubMed/MEDLINE database and performed handsearching of reference lists on the results of those searches. The aetiology and pathophysiology of ADHD are incompletely understood; both genetic and environmental factors have been associated with the disorder and its grade of burden, and also the relationship between the molecular mechanisms of pharmacological treatments and their clinical implications. The lack of comprehensive understanding of the underlying molecular pathology makes both the diagnosis and treatment difficult. Few published studies evaluating molecular data on the mechanism of action (MoA) of MPH and LDX on ADHD are available and most of them are based on animal models. Further studies are necessary to improve the knowledge of ADHD pathophysiology and how the MoAs of MPH and LDX differentially modulate ADHD pathophysiology and control ADHD symptomatology.
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Affiliation(s)
- Javier Quintero
- Servicio de Psiquiatría y Salud Mental, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid, Spain
| | - José R Gutiérrez-Casares
- Unidad Ambulatoria de Psiquiatría y Salud Mental de la Infancia, Niñez y Adolescencia, Hospital Perpetuo Socorro, Badajoz, Spain.
| | - Cecilio Álamo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
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Far transfer effects of executive working memory training on cognitive flexibility. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Studer-Luethi B, Toermaenen M, Margelisch K, Hogrefe AB, Perrig WJ. Effects of Working Memory Training on Children’s Memory and Academic Performance: the Role of Training Task Features and Trainee’s Characteristics. JOURNAL OF COGNITIVE ENHANCEMENT 2022. [DOI: 10.1007/s41465-022-00242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Learning and academic performance are explained mainly by basic limited-capacity processes, most notably by working memory (WM). Consequently, training WM has been considered a promising approach to fostering these abilities. However, school-based investigations are rare. This study examined the effects of training task features and trainees’ characteristics on transfer to cognitive and academic measures. Eighty-six typically developing 8–12-year-old children completed 6 weeks of either WM training with n-back and complex span tasks or a control training with perceptual-matching tasks in a regular school setting. The study also assessed some personal variables of the children, such as neuroticism, conscientiousness, joy of learning, and power of endurance. The WM training group showed increased WM and math performance compared to the control group. Also, there was a trend toward some improvements in vocabulary after WM training, and overall improvements after both trainings were observed in fluid intelligence and reading. Analyses of individual differences in the WM training group indicated increased training performance in relation to emotional stability, conscientiousness, power of endurance, as well as teacher-reported joy of learning and social integration of participants. Thus, the results indicate the potential of WM training to improve WM capacity and mathematical skills and reveal the impact of regulative, motivational, and social factors on cognitive training performance.
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Cognitive Training in the Domain of Mathematics for Potentially Gifted Children in Primary School. EDUCATION SCIENCES 2022. [DOI: 10.3390/educsci12020127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined auditive and visual working memory and metacognitive knowledge in 92 gifted children (aged between eight and twelve), utilising a pre-test-training-post-test design, known as the cognitive training design. This approach was used to examine the working memory and metacognitive knowledge of gifted children concerning the progression after a cognitive training programme in arithmetical problem solving, taking into account the role of intelligence. Children were allocated to one of two experimental conditions: children received training after the pre-test (cognitive training condition) or were provided with training after the post-test (control condition). The results show that all children made significant improvements in working memory and metacognition. Intelligence significantly predicted verbal and visual working memory. However, we did not find a meaningful relationship between intelligence and metacognitive knowledge. The cognitive training in arithmetical problem solving seems to bring additional measurable changes in metacognitive knowledge, but not in working memory.
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Macoun SJ, Schneider I, Bedir B, Sheehan J, Sung A. Pilot Study of an Attention and Executive Function Cognitive Intervention in Children with Autism Spectrum Disorders. J Autism Dev Disord 2021; 51:2600-2610. [PMID: 33029666 DOI: 10.1007/s10803-020-04723-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This pilot study investigated the efficacy of a game-based cognitive training program (Caribbean Quest; CQ) for improving attention and executive function (EF) in school-aged children with Autism Spectrum Disorder (ASD). CQ is a 'serious game' that uses a hybrid process-specific/compensatory approach to remediate attention and EF abilities through repetitive, hierarchically graded exercises delivered in an adaptive format. Game-play is accompanied by instruction in metacognitive strategies delivered by an adult trainer. Twenty children diagnosed with ASD (ages 6-12 years) completed 12 h of intervention in schools over 8-10 weeks that was facilitated by a trained Research Assistant. Pre-post testing indicated near transfer gains for visual working memory and selective attention and far transfer effects for math fluency. Exit interviews with parents and school staff indicated anecdotal gains in attention, EF, emotion-regulation, flexibility, communication, and social skills. Overall, this study provides preliminary support for the feasibility and potential efficacy of the CQ when delivered in schools to children with ASD.
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Affiliation(s)
- Sarah J Macoun
- Psychology Department, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada.
| | - Isabel Schneider
- Psychology Department, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Buse Bedir
- Psychology Department, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - John Sheehan
- Psychology Department, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Andrew Sung
- Educational Psychology Department, University of Victoria, Victoria, BC, Canada
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Clark L, Shelley-Tremblay J, Cwikla J. Shared Developmental Trajectories for Fractional Reasoning and Fine Motor Ability in 4 and 5 Year Olds. Behav Sci (Basel) 2021; 11:26. [PMID: 33672025 PMCID: PMC7919489 DOI: 10.3390/bs11020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 11/16/2022] Open
Abstract
We investigated preschool-aged children's understanding of early fractional tasks and how that performance correlates with fine motor skills and use of gestures while counting. Participants were 33 preschoolers aged 4 to 5 in two Southeastern public elementary schools. Children were tested individually in an interview-like setting. Mathematics tasks were presented in a paper and pencil format and the Grooved Pegboard test assessed fine motor skills. Finally, utilization of gestures was evaluated by taking a behavioral rating of the child's hand morphology, accuracy of gestures, and synchrony of gestures and spoken word while performing a counting task. Results indicate that performance on fractional reasoning tasks significantly predicts both fine motor ability and accuracy of gestures.
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Affiliation(s)
- Lindsey Clark
- Department of Psychology, University of South Alabama, Mobile, AL 36688, USA;
| | | | - Julie Cwikla
- Creativity & Innovation in STEM, University of Southern Mississippi, Hattiesburg, MS 39406, USA;
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Stavroulaki V, Giakoumaki SG, Sidiropoulou K. Working memory training effects across the lifespan: Evidence from human and experimental animal studies. Mech Ageing Dev 2020; 194:111415. [PMID: 33338498 DOI: 10.1016/j.mad.2020.111415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 11/23/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Working memory refers to a cognitive function that provides temporary storage and manipulation of the information necessary for complex cognitive tasks. Due to its central role in general cognition, several studies have investigated the possibility that training on working memory tasks could improve not only working memory function but also increase other cognitive abilities or modulate other behaviors. This possibility is still highly controversial, with prior studies providing contradictory findings. The lack of systematic approaches and methodological shortcomings complicates this debate even more. This review highlights the impact of working memory training at different ages on humans. Finally, it demonstrates several findings about the neural substrate of training in both humans and experimental animals, including non-human primates and rodents.
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Affiliation(s)
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, Gallos University Campus, University of Crete, Rethymno, 74100, Crete, Greece; University of Crete Research Center for the Humanities, The Social and Educational Sciences, University of Crete, Rethymno, 74100, Crete, Greece
| | - Kyriaki Sidiropoulou
- Dept of Biology, University of Crete, Greece; Institute of Molecular Biology and Biotechnology - Foundation for Research and Technology Hellas, Greece.
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Hasslinger J, D’Agostini Souto M, Folkesson Hellstadius L, Bölte S. Neurofeedback in ADHD: A qualitative study of strategy use in slow cortical potential training. PLoS One 2020; 15:e0233343. [PMID: 32497051 PMCID: PMC7272030 DOI: 10.1371/journal.pone.0233343] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/03/2020] [Indexed: 12/03/2022] Open
Abstract
Neurofeedback (NF) as a treatment for children and adolescents with attention deficit hyperactivity disorder (ADHD) has gained growing interest in recent years. Most research has been quantitative, focusing on treatment outcomes, while qualitative approaches exploring the treatment process and participants’ experiences are scarce. The objective of this study was to examine NF participants’ use of cognitive and other strategies for approaching and solving NF tasks, their development over the course of the training and the influence of participants’ compliance.
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Affiliation(s)
- John Hasslinger
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- * E-mail:
| | - Manoela D’Agostini Souto
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Lisa Folkesson Hellstadius
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia
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Child Motivation and Family Environment Influence Outcomes of Working Memory Training in Extremely Preterm Children. JOURNAL OF COGNITIVE ENHANCEMENT 2019. [DOI: 10.1007/s41465-019-00138-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cao P, Xing J, Cao Y, Cheng Q, Sun X, Kang Q, Dai L, Zhou X, Song Z. Clinical effects of repetitive transcranial magnetic stimulation combined with atomoxetine in the treatment of attention-deficit hyperactivity disorder. Neuropsychiatr Dis Treat 2018; 14:3231-3240. [PMID: 30538481 PMCID: PMC6263241 DOI: 10.2147/ndt.s182527] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with atomoxetine (ATX) in the treatment of attention-deficit hyperactivity disorder (ADHD). METHODS Sixty-four patients with newly diagnosed ADHD were enrolled from January 2016 to October 2017 from Psychological Centre for Adolescents and Children at 102th Hospital of People's Liberation Army of China. These patients were randomly assigned to three groups according to treatment method: the rTMS group, the ATX group, and the rTMS+ ATX group. Before treatment and 6 weeks after treatment, clinical symptoms and executive functions of ADHD patients were evaluated with the Swanson, Nolan, and Pelham, Version IV (SNAP-IV) Questionnaire, continuous performance test, three subtests (arithmetic, digit span, and coding) of Wechsler Intelligence Scale for Children, as well as Iowa Gambling Tasks (IGT). The effects of treatment were compared among three groups. RESULTS After 6 weeks of treatment, the scores of all factors in the SNAP-IV questionnaire were lower than those before treatment in the three groups; the scores of three subtests of Wechsler Intelligence Scale for Children, continuous performance test, and IGT were also significantly higher than those before treatment. The rTMS+ ATX group had a better improvement in attention deficits and hyperactivity impulse on the SNAP-IV questionnaire compared with the other groups, and also had a higher efficacy on cold and hot executive functions such as arithmetic, forward numbers, coding, and IGT. In addition, the ATX group performed better than the rTMS group in coding and IGT. CONCLUSION rTMS, ATX, and the combination therapy are effective in improving core symptoms and executive function in patients with ADHD. The combined treatment has significant therapeutic advantages over the single treatment groups. Compared with rTMS, the drug therapy has a better improvement in coding and IGT.
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Affiliation(s)
- Pengfei Cao
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China, .,Department of Political Affairs, College of Politics, National Defense University of People's Liberation Army of China, Beijing, China
| | - Jun Xing
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Yin Cao
- Laboratory of Neurological Diseases, Department of Neurology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, China,
| | - Qi Cheng
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Xiaojing Sun
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Qi Kang
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Libin Dai
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Xianju Zhou
- Laboratory of Neurological Diseases, Department of Neurology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, China,
| | - Zixiang Song
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
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