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Zhang DW. Perspectives on heterogeneity-informed cognitive training for attention-deficit/hyperactivity disorder. Front Psychiatry 2023; 13:1100008. [PMID: 36713921 PMCID: PMC9878183 DOI: 10.3389/fpsyt.2022.1100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/30/2022] [Indexed: 01/13/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (AD/HD) is a heterogeneous neurodevelopmental condition, posing a severe threat to quality of life. Pharmacological therapies are the front-line treatment; however, their shortages encourage the development of alternative treatments for AD/HD. One promising method of developing alternative treatments is cognitive training (CT). A CT-based therapy was recently approved by the US Food and Drug Administration. However, due to heterogeneity in AD/HD, a CT protocol is unlikely to provide a one-size-fits-all solution for all patients with AD/HD. Therefore, this article highlights key aspects that need to be considered to further develop CT protocols for AD/HD, regarding training content, timing, suitability, and delivery mode. The perspectives presented here contribute to optimizing CT as an alternative option for treating AD/HD.
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Affiliation(s)
- Da-Wei Zhang
- Department of Psychology and Center for Place-Based Education, Yangzhou University, Yangzhou, China
- Department of Psychology, Monash University Malaysia, Bandar Sunway, Malaysia
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Luo X, Guo X, Zhao Q, Zhu Y, Chen Y, Zhang D, Jiang H, Wang Y, Johnstone S, Sun L. A randomized controlled study of remote computerized cognitive, neurofeedback, and combined training in the treatment of children with attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-01956-1. [PMID: 35182242 PMCID: PMC8857637 DOI: 10.1007/s00787-022-01956-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/02/2022] [Indexed: 12/04/2022]
Abstract
There is an increasing interest in non-pharmacological treatments for children with attention-deficit/hyperactivity disorder (AD/HD), especially digital techniques that can be remotely delivered, such as neurofeedback (NFT) and computerized cognitive training (CCT). In this study, a randomized controlled design was used to compare training outcomes between remotely delivered NFT, CCT, and combined NFT/CCT training approaches. A total of 121 children with AD/HD were randomly assigned to the NFT, CCT, or NFT/CCT training groups, with 80 children completing the training program. Pre- and post-training symptoms (primary outcome), executive and daily functions were measured using questionnaires as well as resting EEG during eyes-closed (EC) and eyes-open (EO) conditions. After 3 months of training, the inattentive and hyperactive/impulsive symptoms, inhibition, working memory, learning and life skills of the three groups of children were significantly improved. The objective EEG activity showed a consistent increase in the relative alpha power in the EO condition among the three training groups. Training differences were not observed between groups. There was a positive correlation between pre-training EO relative alpha power and symptom improvement scores of inattention and hyperactivity/impulsivity, as well as a negative correlation between pre-training inattention scores and change in EO relative alpha. This study verified the training effects of NFT, CCT, and combined NFT/CCT training in children with AD/HD and revealed an objective therapeutic role for individual relative alpha activity. The verified feasibility and effectiveness of home-based digital training support promotion and application of digital remote training.
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Affiliation(s)
- Xiangsheng Luo
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Xiaojie Guo
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Qihua Zhao
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Yu Zhu
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Yanbo Chen
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Dawei Zhang
- Department of Psychology, School of Educational Science, Yangzhou University, Jiangsu, People’s Republic of China
| | - Han Jiang
- School of Special Education, Zhejiang Normal University, Hangzhou, People’s Republic of China
| | - Yufeng Wang
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Stuart Johnstone
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia. .,Brain and Behavior Research Institute, University of Wollongong, Wollongong, NSW, 2500, Australia.
| | - Li Sun
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People's Republic of China. .,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191, People's Republic of China.
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