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Hou Y, Liu W, He T, Chen A. Association between the performance of executive function and the remission of depressive state after clinical treatment in patients with depression. J Affect Disord 2024:S0165-0327(24)01195-9. [PMID: 39038627 DOI: 10.1016/j.jad.2024.07.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 07/09/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Previous studies have reported that patients with depression have significant cognitive impairment. The aim of this study is to comprehensively evaluate the impairment of executive functions in patients with depression and whether the cognitive behavior performance of executive function is association with remission of depressive state after clinical treatment. METHODS We used cognitive-behavioral test to evaluate the performance of executive functions of 95 inpatients with depression before hospitalization and conducted two follow-up evaluations of their depression status on the 15th day of hospitalization and approximately 9 months after discharge. RESULTS The performance of executive function except the accuracy of inhibition control in patients with depression were significantly worse than that of healthy controls. Multivariate linear regression analysis found that the reaction time of working memory not only had a significant linear relationship with the baseline depression scores of patients with depression, but also had a significant linear relationship with the reduced depression scores after two follow-up visits. LIMITATIONS We only used cognitive-behavioral data as indicators to evaluate the cognitive performances of participants and only measured three components of executive function. CONCLUSIONS The reaction time of working memory was a stable and effective predictor of symptom relief in patients with depression after clinical treatment. These results provide initial evidence for working memory to predict the clinical prognosis of inpatients with depression prospectively, which could be further leveraged to improve intervention approaches and analyze the heterogeneity of depression.
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Affiliation(s)
- Yongqing Hou
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; National Health Commission and Chinese Academy of Medical Sciences Key Laboratory of Medical Neurobiology, Ministry of Education Frontier Center of Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China; Mental Health Center of Guangyuan, Sichuan, Guangyuan 628000, China.
| | - Wen Liu
- Mental Health Center of Guangyuan, Sichuan, Guangyuan 628000, China
| | - Tianbao He
- Mental Health Center of Guangyuan, Sichuan, Guangyuan 628000, China
| | - Antao Chen
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China.
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Luo J, Li F, Wu Y, Liu X, Zheng Q, Qi Y, Huang H, Xu G, Liu Z, He F, Zheng Y. A mobile device-based game prototype for ADHD: development and preliminary feasibility testing. Transl Psychiatry 2024; 14:251. [PMID: 38858375 PMCID: PMC11164876 DOI: 10.1038/s41398-024-02964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 05/13/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024] Open
Abstract
This research aimed to devise and assess a mobile game therapy software for children with Attention-Deficit/Hyperactivity Disorder (ADHD), as well as evaluating its suitability and effectiveness in improving the cognitive ability of typically developing children. The study encompassed 55 children diagnosed with ADHD and 55 neurotypical children. Initial assessments involved ADHD-related scales, computerized tests for information processing, and physiological-psychological evaluations. After a 4-week home-based game intervention, participants underwent re-evaluation using baseline measures and provided feedback on treatment satisfaction. Considering the small proportion of study participants who dropped out, data was analyzed using both the Intention-to-Treat (ITT) analysis and the Per-protocol (PP) analysis. The trial was registered at ClinicalTrials.gov (NCT06181747). In ITT analysis, post-intervention analysis using linear mixed models indicated that the ADHD group improved significantly more than the neurotypical group particularly in Continuous Performance Test (CPT) accuracy (B = -23.92, p < 0.001) and reaction time (B = 86.08, p < 0.01), along with enhancements in anti-saccade (B = -10.65, p < 0.05) and delayed-saccade tasks (B = 0.34, p < 0.05). A reduction in parent-rated SNAP-IV scores was also observed (B = 0.43, p < 0.01). In PP analysis, paired-sample t-tests suggested that the ADHD group had significant changes pre- and post-intervention, in terms of CPT Accuracy (t = -7.62, p < 0.01), Anti-saccade task Correct Rate (t = -3.90, p < 0.01) and SNAP-IV scores (t = -4,64, p < 0.01). However, no significant changes post-intervention were observed in the neurotypical group. Survey feedback highlighted a strong interest in the games across both groups, though ADHD participants found the game more challenging. Parents of ADHD children reported perceived benefits and a willingness to continue the game therapy, unlike the neurotypical group's parents. The findings advocated for the integration of serious video games as a complementary tool in ADHD treatment strategies, demonstrating the potential to augment attentional abilities and alleviate clinical symptoms. However, a randomized controlled trial (RCT) is needed to further verify its efficacy.
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Affiliation(s)
- Jie Luo
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Fenghua Li
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yuanzhen Wu
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Xuanang Liu
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Qingyi Zheng
- Department of Psychology and Human Development, Institute of Education, University College London, London, UK
| | - Yanjie Qi
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Huanhuan Huang
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Gaoyang Xu
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Zhengkui Liu
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Fan He
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China.
| | - Yi Zheng
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China.
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Chacko A, Merrill BM, Kofler MJ, Fabiano GA. Improving the efficacy and effectiveness of evidence-based psychosocial interventions for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. Transl Psychiatry 2024; 14:244. [PMID: 38851829 PMCID: PMC11162428 DOI: 10.1038/s41398-024-02890-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/14/2024] [Accepted: 03/22/2024] [Indexed: 06/10/2024] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent, chronic, and impairing mental health disorder of childhood. Decades of empirical research has established a strong evidence-based intervention armamentarium for ADHD; however, limitations exist in regards to efficacy and effectiveness of these interventions. We provide an overview of select evidence-based interventions for children and adolescents, highlighting potential approaches to further improving the efficacy and effectiveness of these interventions. We conclude with broader recommendations for interventions, including considerations to moderators and under-explored intervention target areas as well as avenues to improve access and availability of evidence-based interventions through leveraging underutilized workforces and leveraging technology.
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Nejati V, Peyvandi A. The impact of time perception remediation on cold and hot executive functions and behavioral symptoms in children with ADHD. Child Neuropsychol 2024; 30:636-651. [PMID: 37646622 DOI: 10.1080/09297049.2023.2252962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
Children with ADHD struggle with impaired time management, indicating premature and temporally inadequate behavioral style. This study aimed to evaluate the impact of time perception remediation on hot and cold executive functions (EFs) and behavioral symptoms in children with ADHD. In this pilot study, an RCT design was employed to investigate the effects of the intervention on children with ADHD. The participants were assigned to either the control group (n = 15) or the intervention group (n = 13). The intervention group receive 10-12 sessions of program for attentive remediation of time perception (PART). Time perception, N-back, Wisconsin card sorting, Go/No-Go, balloon analog risk, Iowa gambling tasks, and Conner's parental rating scale were used for the assessment in three baseline, post-intervention, and follow-up sessions. Repeated measures ANOVAs were used for analysis. The results suggest improved time perception and risky decision making in intervention group. Working memory, inhibitory control, and cognitive flexibility did not improve after intervention. The behavioral symptoms ameliorated after intervention. Time perception is trainable in children with ADHD. This training effect transfers to hot EFs and behavioral symptoms, but not cold EFs. A cognitive model has been proposed based on the results of this studies and other cognitive training studies.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Aida Peyvandi
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
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Del Lucchese B, Parravicini S, Filogna S, Mangani G, Beani E, Di Lieto MC, Bardoni A, Bertamino M, Papini M, Tacchino C, Fedeli F, Cioni G, Sgandurra G. The wide world of technological telerehabilitation for pediatric neurologic and neurodevelopmental disorders - a systematic review. Front Public Health 2024; 12:1295273. [PMID: 38694988 PMCID: PMC11061864 DOI: 10.3389/fpubh.2024.1295273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/08/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction The use of Information and Communication Technology (ICT) for assessing and treating cognitive and motor disorders is promoting home-based telerehabilitation. This approach involves ongoing monitoring within a motivating context to help patients generalize their skills. It can also reduce healthcare costs and geographic barriers by minimizing hospitalization. This systematic review focuses on investigating key aspects of telerehabilitation protocols for children with neurodevelopmental or neurological disorders, including technology used, outcomes, caregiver involvement, and dosage, to guide clinical practice and future research. Method This systematic review adhered to PRISMA guidelines and was registered in PROSPERO. The PICO framework was followed to define the search strategy for technology-based telerehabilitation interventions targeting the pediatric population (aged 0-18) with neurological or neurodevelopmental disorders. The search encompassed Medline/PubMed, EMBASE, and Web of Science databases. Independent reviewers were responsible for selecting relevant papers and extracting data, while data harmonization and analysis were conducted centrally. Results A heterogeneous and evolving situation emerged from our data. Our findings reported that most of the technologies adopted for telerehabilitation are commercial devices; however, research prototypes and clinical software were also employed with a high potential for personalization and treatment efficacy. The efficacy of these protocols on health or health-related domains was also explored by categorizing the outcome measures according to the International Classification of Functioning, Disability, and Health (ICF). Most studies targeted motor and neuropsychological functions, while only a minority of papers explored language or multi-domain protocols. Finally, although caregivers were rarely the direct target of intervention, their role was diffusely highlighted as a critical element of the home-based rehabilitation setting. Discussion This systematic review offers insights into the integration of technological devices into telerehabilitation programs for pediatric neurologic and neurodevelopmental disorders. It highlights factors contributing to the effectiveness of these interventions and suggests the need for further development, particularly in creating dynamic and multi-domain rehabilitation protocols. Additionally, it emphasizes the importance of promoting home-based and family-centered care, which could involve caregivers more actively in the treatment, potentially leading to improved clinical outcomes for children with neurological or neurodevelopmental conditions. Systematic review registration PROSPERO (CRD42020210663).
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Affiliation(s)
- Benedetta Del Lucchese
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Stefano Parravicini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Pediatric Neuroscience Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Silvia Filogna
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Gloria Mangani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Elena Beani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maria Chiara Di Lieto
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | | | - Marta Bertamino
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Marta Papini
- Scientific Institute, IRCCS E. Medea, Lecco, Italy
| | - Chiara Tacchino
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Leung WSW, Pei J, Rasmussen C. A working memory intervention for children with prenatal alcohol exposure: Pilot study. APPLIED NEUROPSYCHOLOGY. CHILD 2024:1-9. [PMID: 38593749 DOI: 10.1080/21622965.2024.2328672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Cogmed© is a computerized working memory training program designed to improve attention and working memory. We examined the short- and long-term impacts of a 25-session Cogmed© intervention on working memory and other cognitive and learning domains in children with prenatal alcohol exposure (PAE) and typically developing children. Participants included 38 children (4 - 13 years old) from Alberta, Canada in two groups: PAE (n = 20) and typically developing (n = 18). Significant improvements in areas of working memory and attentional control for both the PAE and the typically developing group were reported immediately after intervention completion (short-term impact). The gains on some measures were retained at five-week follow up (long-term impact). Preliminary findings indicate that computerized interventions may positively impact WM and attention control and that these changes may be maintained after a delay period.
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Affiliation(s)
| | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Carmen Rasmussen
- Department of Pediatrics, University of Alberta, Edmonton, Canada
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Ruchkin V, Wallonius M, Odekvist E, Kim S, Isaksson J. Memory training with the method of loci for children and adolescents with ADHD-A feasibility study. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:137-145. [PMID: 36344263 DOI: 10.1080/21622965.2022.2141120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to investigate if training with the memory technique Method of Loci (MoL) is feasible for children and adolescents with ADHD. Twelve children (aged 9-17 years) with ADHD participated. Training with MoL was done using a mobile application, memorizing a sequence of 20-80 pictures, intended to be carried out five times per week for 4 weeks. Feasibility was assessed with pre- and post-intervention ratings, and with interviews after the training. Qualitative data were analyzed with content analysis. Those who trained with MoL performed better on memory test and reported fewer ADHD symptoms after completing the training, as compared to their baseline levels. All of these children would recommend the training to peers but the duration of training varied considerably. The participants and their parents reported that the MoL training was easy and fun to use, although lack of motivation, distractions in every-day life, and lack of routines created challenges. We conclude that training with MoL was considered feasible by most of the participants. Future research should try to make the intervention more acceptable by motivating the participants and limiting potential distractions and involving larger study groups and controls to study the efficacy of the training.
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Affiliation(s)
- Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Marwin Wallonius
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Emma Odekvist
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Sharmeen Kim
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
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Wilens TE, Stone M, Lanni S, Berger A, Wilson RLH, Lydston M, Surman CB. Treating Executive Function in Youth With Attention Deficit Hyperactivity Disorder: A Review of Pharmacological and Non-Pharmacological Interventions. J Atten Disord 2024; 28:751-790. [PMID: 38178649 DOI: 10.1177/10870547231218925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
INTRODUCTION Executive function (EF) deficits are common in youth with ADHD and pose significant functional impairments. The extent and effect of interventions addressing EF in youth with ADHD remain unclear. METHODS We conducted a systematic literature review using PRISMA guidelines. Included studies were randomized controlled trials of interventions to treat EF in youth with ADHD. RESULTS Our search returned 136 studies representing 11,443 study participants. We identified six intervention categories: nonstimulant pharmacological (N = 3,576 participants), neurological (N = 1,935), psychological (N = 2,387), digital (N = 2,416), physiological (N = 680), and combination (N = 366). The bulk of the evidence supported pharmacological interventions as most effective in mitigating EF, followed by psychological and digital interventions. CONCLUSION A breadth of treatments exists for EF in youth with ADHD. Pharmacological, psychotherapeutic, and digital interventions had the most favorable, replicable outcomes. A lack of outcome standardization across studies limited treatment comparison. More data on the persistence of intervention effects are necessary.
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Affiliation(s)
- Timothy E Wilens
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mira Stone
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Amy Berger
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Craig B Surman
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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9
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Bombonato C, Del Lucchese B, Ruffini C, Di Lieto MC, Brovedani P, Sgandurra G, Cioni G, Pecini C. Far Transfer Effects of Trainings on Executive Functions in Neurodevelopmental Disorders: A Systematic Review and Metanalysis. Neuropsychol Rev 2024; 34:98-133. [PMID: 36633797 PMCID: PMC10920464 DOI: 10.1007/s11065-022-09574-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 12/01/2022] [Indexed: 01/13/2023]
Abstract
Executive Functions are a set of interrelated, top-down processes essential for adaptive goal-directed behaviour, frequently impaired across different neurodevelopmental disorders with variable degrees of severity. Many executive-function-training studies in children with neurodevelopmental disorders have focused on near effects, investigating post-treatment improvements on directly trained processes, while enhancements of skills not directly trained, defined as far effects, are less considered, albeit these could be extremely relevant for reducing the negative impact of a disorder's core symptomatology. This systematic review and metanalysis aims to investigate the far effect outcomes after EF training in children with different types of neurodevelopmental disorders. 17 studies met the inclusion criteria for the systematic review, while 15 studies were selected in the metanalysis. An overall statistically significant effect size was found in the majority of far effect outcome measures considered in the studies. In particular, trainings on executive functions determine significant far effects on daily life functioning (0.46, 95% CI: [0.05-0.87]) and clinical symptoms (0.33, 95% CI: [0.15-0.51]). Despite a high variability of the results, intensity, frequency and the laboratory/life contexts dimension seem to be the most influential variables in determining far effects. This systematic review and metanalysis highlights the need to measure far effects of executive function training in neurodevelopmental disorders, selecting treatments not only on directly targeted processes, but also according to far impacts on the functional weakness of the disorder.
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Affiliation(s)
- Clara Bombonato
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
- Tuscan Programme of Neuroscience, University of Florence, Pisa and Siena, Italy
| | - Benedetta Del Lucchese
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
- Tuscan Programme of Neuroscience, University of Florence, Pisa and Siena, Italy
| | - Costanza Ruffini
- Department of Education, Intercultures, Literatures and Psychology (FORLIPSI), University of Florence, Languages, Florence, Italy
| | - Maria Chiara Di Lieto
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - Paola Brovedani
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy.
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - Chiara Pecini
- Department of Education, Intercultures, Literatures and Psychology (FORLIPSI), University of Florence, Languages, Florence, Italy
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10
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Rodas JA, Asimakopoulou AA, Greene CM. Can we enhance working memory? Bias and effectiveness in cognitive training studies. Psychon Bull Rev 2024:10.3758/s13423-024-02466-8. [PMID: 38366265 DOI: 10.3758/s13423-024-02466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/18/2024]
Abstract
Meta-analyses have found that working memory (WM) can be improved with cognitive training; however, some authors have suggested that these improvements are mostly driven by biases in the measurement of WM, especially the use of similar tasks for assessment and training. In the present meta-analysis, we investigated whether WM, fluid intelligence, executive functions, and short-term memory can be improved by cognitive training and evaluated the impact of possible sources of bias. We performed a risk of bias assessment of the included studies and took special care in controlling for practice effects. Data from 52 independent comparisons were analyzed, including cognitive training aimed at different cognitive functions. Our results show small improvements in WM after training (SMD = 0.18). Much larger effects were observed when the analysis was restricted to assessment tasks similar to those used for training (SMD = 1.15). Fluid intelligence was not found to improve as a result of training, and improvements in WM were not related to changes in fluid intelligence. Our analyses did however indicate that cognitive training can improve specific executive functions. Contrary to expectations, a set of meta-regressions indicated that characteristics of the training programme, such as dosage and type of training, do not have an impact on the effectiveness of training. The risk of bias assessment revealed some concerns in the randomization process and possible selective reporting among studies. Overall, our results identified various potential sources of bias, with the most significant being the choice of assessment tasks.
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Affiliation(s)
- Jose A Rodas
- Escuela de Psicología, Universidad Espíritu Santo, Samborondón, Ecuador.
- School of Psychology, University College Dublin, Dublin, Ireland.
| | | | - Ciara M Greene
- School of Psychology, University College Dublin, Dublin, Ireland
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Nejati V, Derakhshan Z. Attention Training Improves Executive Functions and Ameliorates Behavioral Symptoms in Children with Attention-Deficit Hyperactivity Disorder: Implication of Tele-Cognitive-Rehabilitation in the Era of Coronavirus Disease. Games Health J 2024; 13:40-49. [PMID: 38300525 DOI: 10.1089/g4h.2023.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Background: Children with attention-deficit hyperactivity disorder (ADHD) struggle with impaired attention, leading to impaired executive function and behavioral symptoms. In this study, we aimed to evaluate the effect of attention training on executive functions and behavioral symptoms in children with ADHD, in a tele-cognitive-rehabilitation setting. Methods: Thirty children (mean age: 9.93 ± 1.68 years, 21 boys) with ADHD were randomly assigned to 2 equal groups of attention training and active control group. Attentive Rehabilitation and Improvement of Attention (ARIA) and a class of storytelling were used for intervention in two groups, in an online platform. Continuous performance test, one-back test, Wisconsin card sorting test (WCST), Conner's parent rating scale, and behavioral rating inventory of executive function (BRIEF) were used for assessment in three-baseline, postintervention, and follow-up sessions. Repeated measures analysis of variances were used for analysis. Results: ARIA leads to significant improvement in omission error (P < 0.001), commission error (P = 0.006), and response time (P = 0.005) of continuous performance test, cluster (P = 0.001), but not preservation error (P = 0.110) of WCST, accuracy of NBT (P = 0.004) and the score of Conner's parent rating scale (P < 0.001) and BRIEF (P < 0.001). These results indicate improved attention and executive functions, amelioration of ADHD symptoms, and improved behavioral performance. Conclusion: This study suggests that attention can be trained through tele-cognitive rehabilitation using a remediation program in children with ADHD. The effectiveness of this training can be confirmed by examining the transfer of training effects to other untrained cognitive domains, executive functions, symptoms of ADHD, and behavioral performance.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Zahra Derakhshan
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
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12
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Bemanalizadeh M, Yazdi M, Yaghini O, Kelishadi R. A meta-analysis on the effect of telemedicine on the management of attention deficit and hyperactivity disorder in children and adolescents. J Telemed Telecare 2024; 30:31-43. [PMID: 34633251 DOI: 10.1177/1357633x211045186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aims to report the effect sizes of telemedicine treatments on the symptom domains of paediatric ADHD. METHODS In this systematic review and meta-analysis, electronic databases, i.e. PubMed, Scopus, Web of Science and Embase, were searched for articles published up to December 2020. The inclusion criteria were as follows: children or adolescents diagnosed for ADHD or other hyperkinetic disorders; randomized controlled trials (RCTs); efficacy established with parents and teachers or self-rating scales at least for one of the following domains: inattention, cognitive function, hyperactivity, hyperactivity/impulsivity or oppositional behaviours. The risk of bias was assessed using the Cochrane risk of bias tool for RCTs. RESULTS From 310 records reduced to 228 after removing duplicates, overall 12 studies were fulfilled our inclusion criteria. They consisted of 708 participants (358 with telemedicine intervention and 350 controls). The telemedicine interventions varied from computerized training programmes with phone calls to videoconferencing programmes, virtual reality classrooms or games. The most applicable method consisted of computerized training programmes with phone calls. Pooling results of all studies with available data on each subscale showed a significant effect of telemedicine on inattention/cognitive function (standardized mean difference (SMD) = 0.26, 95% CI: 0.16, 0.36), hyperactivity/impulsivity (SMD = 0.29, 95% CI: 0.06, 0.52), and oppositional behaviours (SMD = 0.72, 95% CI: 0.24, 1.20) subscales in ADHD. Almost all studies had an overall unclear risk of bias. The source of outcome assessment (parents, teachers or self-report questionnaire) was addressed as a potential confounding factor. In almost all symptom domains, the satisfaction from the treatment was higher in parents than in teachers. CONCLUSIONS The clinical effects of telemedicine on the treatment of ADHD showed a small effect size for inattention/cognitive function, hyperactivity/impulsivity and oppositional behaviours.
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Affiliation(s)
- Maryam Bemanalizadeh
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Iran
| | - Maryam Yazdi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Iran
| | - Omid Yaghini
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Iran
- Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Iran
- Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Iran
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Caselles‐Pina L, Sújar A, Quesada‐López A, Delgado‐Gómez D. Adherence, frequency, and long-term follow-up of video game-based treatments in patients with attention-deficit/hyperactivity disorder: A systematic review. Brain Behav 2023; 13:e3265. [PMID: 37743605 PMCID: PMC10636395 DOI: 10.1002/brb3.3265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children and adolescents. Recent studies show that video games have great potential for the treatment and rehabilitation of ADHD patients. The aim of the present review is to systematically review the scientific literature on the relationship between video games and ADHD, focusing on adherence to treatment, frequency of the intervention, and the long-term follow-up of video games in children and adolescents with ADHD. METHODS The preferred reporting items for systematic reviews and meta-analyses guidelines were adopted. The review protocol was registered in PROSPERO database. We searched in three databases, PubMed, Medline, and Web of Science to identify studies examining the association between video game interventions in ADHD patients. RESULTS A total of 18 empirical studies met the established inclusion criteria. The results showed that video games-based interventions can be used to improve ADHD symptoms and display high adherence to treatment. In addition, in the studies reviewed, the most common intervention frequency is 30 min three to five times per week. However, there is little evidence from studies with video games showing long-term effects in patients with ADHD. CONCLUSION Video games are useful and effective interventions that can complement traditional treatments in patients with ADHD.
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Affiliation(s)
- Lucía Caselles‐Pina
- Department of StatisticsUniversidad Carlos III de MadridGetafeSpain
- Department of PsychologyUniversidad Autónoma de MadridMadridSpain
| | - Aaron Sújar
- School of Computer EngineeringUniversidad Rey Juan CarlosMóstolesSpain
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Bos E, Preller KH, Kaur G, Malhotra P, Kharawala S, Motti D. Challenges With the Use of Digital Sham: Systematic Review and Recommendations. J Med Internet Res 2023; 25:e44764. [PMID: 37874638 PMCID: PMC10630857 DOI: 10.2196/44764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/26/2023] [Accepted: 07/20/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Digital therapeutics (DTx) are software-based products that prevent, manage, or treat a medical condition and are delivered through a smartphone app, web application, or wearable device. Clinical trials assessing DTx pose challenges, foremost among which is designing appropriate digital shams (or digital placebos), which should ideally mimic DTx (in terms of design, components, and duration of treatment) while omitting the active principle or component. OBJECTIVE The objective of our review was to understand how digital shams are being used in clinical research on DTx in neuroscience, which is the most common therapy area for DTx. METHODS We conducted a systematic literature review of DTx in neuroscience (including neurodevelopmental, neurodegenerative, and psychiatric disorders) with a focus on controlled clinical trials involving digital shams. Studies were identified from trial registries (ClinicalTrials.gov, the European Union Clinical Trials Register, and Trial Trove) and through structured searches in MEDLINE and Embase (both via the Embase website) and were limited to articles in English published from 2010 onward. These were supplemented by keyword-based searches in PubMed, Google, and Google Scholar and bibliographic searches. Studies assessing DTx in neuroscience (including neurodevelopmental, neurodegenerative, and psychiatric disorders) were included. Details related to the publication, DTx, comparator, patient population, and outcomes were extracted and analyzed. RESULTS Our search criteria identified 461 neuroscience studies involving 213 unique DTx. Most DTx were extended reality based (86/213, 40.4%) or mobile device based (56/213, 26.3%); 313 were comparative, of which 68 (21.7%) used shams. The most common therapeutic areas assessed in these studies were stroke (42/213, 19.7%), depression (32/213, 15%), and anxiety (24/213, 11.3%). The most common treatments were cognitive behavioral therapy or behavioral therapy (67/213, 32.4%), physical rehabilitation (60/213, 28.2%), and cognitive training (41/213, 19.2%). We identified the following important issues related to the use of digital shams in neuroscience: shams were not validated before use in studies, they varied widely in design (from being nearly identical to the DTx to using different software programs altogether), and the level of patient engagement or satisfaction with the sham and the impact of the sham on study outcomes were infrequently reported. CONCLUSIONS Digital shams are critical for the clinical development of DTx in neuroscience. Given the importance of sham controls in evaluating DTx efficacy, we provide recommendations on the key information that should be reported in a well-designed DTx trial and propose an algorithm to allow the correct interpretation of DTx study results. Sham-controlled studies should be routinely used in DTx trials-in early-phase studies-to help identify DTx active components and-in late-phase studies-to confirm the efficacy of DTx. The use of shams early in development will ensure that the appropriate sham control is used in later confirmatory trials.
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Affiliation(s)
- Ernst Bos
- F Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Gavneet Kaur
- Bridge Medical Consulting Limited, London, United Kingdom
| | - Pooja Malhotra
- Bridge Medical Consulting Limited, London, United Kingdom
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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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Qiu H, Liang X, Wang P, Zhang H, Shum DHK. Efficacy of non-pharmacological interventions on executive functions in children and adolescents with ADHD: A systematic review and meta-analysis. Asian J Psychiatr 2023; 87:103692. [PMID: 37450981 DOI: 10.1016/j.ajp.2023.103692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Although front-line doctors recommend medications, this kind of treatment has limited efficacy in improving executive functions (EFs) in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). This study explored the effects of non-pharmacological intervention on EFs in children and adolescents with ADHD. METHODS In accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, we searched seven electronic databases: APA PsycINFO, CINAHL Complete, EMBASE, ERIC, Medline, Pubmed, and Web of Science, from inception to March 2022. Two authors independently screened studies for eligibility, extracted data, and assessed bias risk using the Physiotherapy Evidence Database scale. Our analyses included randomized controlled trials and non-randomized comparison studies of non-pharmacological interventions and assessed EFs through neurocognitive tasks in children and adolescents between 5 and 18 years. RESULTS Sixty-seven studies with 3147 participants met the inclusion criteria. The final meta-analysis included 74 independent interventions categorized into six categories: cognitive training, EF-specific curriculum, game-based training, mindfulness practice, neurofeedback training, and physical exercise. Overall, non-pharmacological interventions (combined) produced significant moderate to large effects on overall EFs in children and adolescents with ADHD (g=0.673). Physical exercise had a large positive effect on domain-specific EFs, including inhibitory control (g=0.900) and cognitive flexibility (g=1.377). Cognitive training had a large training effect on working memory (g=0.907), and an EF-specific curriculum had a small to moderate beneficial effect on planning performance (g=0.532). CONCLUSION Non-pharmacological interventions, particularly physical exercise, cognitive training, and an EF-specific curriculum, appear to have beneficial effects on EFs in children and adolescents with ADHD.
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Affiliation(s)
- Hui Qiu
- Department of Educational Administration and Policy, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiao Liang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.
| | - Peng Wang
- Center for Lifestyle Medicine, Fuwai Hospital, Chinese Academy of Medical, Sciences & Peking Union Medical College, Beijing, China
| | - Hui Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China; Research Institute for Intelligent Wearable Systems, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - David H K Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
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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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18
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Paradela RS, Cabella B, Nucci MP, Ferreira NV, Torres LA, Martino LM, Consolim-Colombo FM, Bortolotto LA, da Costa DI, Irigoyen MC. Computerized working memory training for hypertensive individuals with executive function impairment: a randomized clinical trial. Front Neurosci 2023; 17:1185768. [PMID: 37483358 PMCID: PMC10361818 DOI: 10.3389/fnins.2023.1185768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Background Hypertension is associated with working memory (WM) impairment. However, the benefits of Cogmed WM training for the hypertensive population are unknown. Therefore, we aimed to evaluate Cogmed's effects on the WM performance of hypertensive individuals with executive function (EF) impairment. Methods We included 40 hypertensive patients (aged 40-70 years, 68% female) with EF impairment. They were randomized in a 1:1 ratio to receive 10 weeks of adaptive Cogmed training or a non-adaptive control training based on online games. The primary outcome was the WM performance. The secondary outcomes were verbal memory, visuospatial ability, executive function, global cognition, and the neuronal activity measured using functional magnetic resonance imaging (fMRI) under two WM task conditions: low (memorization of 4 spatial locations) and high (memorization of 6 spatial locations). An intention-to-treat (ITT) and per-protocol (PP) analysis were performed. Results Cogmed did not show a significant effect on WM or any other cognitive outcome post-training. However, under the WM-low load and WM-high load conditions of the fMRI, respectively, the Cogmed group had an activation decrease in the right superior parietal lobe (ITT and PP analyses) and left inferior frontal lobe (PP analysis) in comparison to the control group. Conclusion The Cogmed showed no effects on the WM performance of hypertensive individuals with EF impairment. However, activation decreases were observed in frontoparietal areas related to the WM network, suggesting a more efficient neuronal activity after training.
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Affiliation(s)
- Regina Silva Paradela
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Brenno Cabella
- Institute of Theoretical Physics, São Paulo State University (IFT-UNESP), São Paulo, Brazil
| | - Mariana Penteado Nucci
- Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Naomi Vidal Ferreira
- Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil
- Research Affairs Office, Amazonia Adventist College, Benevides, Pará, Brazil
| | - Laura Aló Torres
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Luiza Menoni Martino
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Luiz Aparecido Bortolotto
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Danielle Irigoyen da Costa
- Brain Institute (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Maria Claudia Irigoyen
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Almarzouki AF, Bellato A, Al-Saad MS, Al-Jabri B. COGMED working memory training in children with Attention Deficit/Hyperactivity Disorder (ADHD): A feasibility study in Saudi Arabia. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:202-213. [PMID: 35549563 DOI: 10.1080/21622965.2022.2070020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Working memory training has been proven effective for improving cognitive functioning in patients with Attention Deficit/Hyperactivity Disorder (ADHD). However, the feasibility of this type of training for children in Saudi Arabia has not been previously explored. We investigated the feasibility of implementing Cogmed Working Memory Training (CWMT) in a sample of 29 Saudi children with ADHD. We found no significant demographic or clinical differences between compliant and noncompliant children. Although compliant children were initially better at following instructions and reported better improvements in working memory and math skills compared to those who did not complete the CWMT, all children who participated in the program showed improvements in performing the CWMT tasks. Most parents found the Cogmed training feasible for their children, were satisfied and keen to continue with the program, and felt the training helped them to address their problems. Most children did not encounter any difficulties in using the software, and many families were, therefore, likely to continue using the techniques from the program. We conclude that CWMT for children with ADHD is feasible in Saudi Arabia. Larger case-controlled studies are needed to thoroughly investigate the effects of CWMT compared to other interventions in Saudi children with ADHD.
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Affiliation(s)
- Abeer F Almarzouki
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alessio Bellato
- Institute of Psychology, Psychiatry and Neuroscience (IoPPN), King's College London, London, UK
- School of Psychology, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Maha S Al-Saad
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- General Directorate of Health Affairs in Najran, Ministry of Health, Najran, Saudi Arabia
| | - Basma Al-Jabri
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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He F, Qi Y, Zhou Y, Cao A, Yue X, Fang S, Zheng Y. Meta-analysis of the efficacy of digital therapies in children with attention-deficit hyperactivity disorder. Front Psychiatry 2023; 14:1054831. [PMID: 37260755 PMCID: PMC10228751 DOI: 10.3389/fpsyt.2023.1054831] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/26/2023] [Indexed: 06/02/2023] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that commonly occurs in childhood. The aim of this meta-analysis was to summarize the available evidence for the efficacy of digital therapeutics in children and adolescents with ADHD. Methods We searched the MEDLINE, EMBASE, Cochrane Library (Cochrane Database of Systematic Reviews), and Web of Science (science and social science citation index) databases for relevant studies and used Stata 15.0 software to carry out the meta-analysis. Results A total of 31 studies involving 2169 participants (1665 boys and 504 girls) aged 4-17 years old were included in the final analysis. The meta-analysis results showed that digital interventions improved the symptoms of inattention with an effect value of -0.20 (95% confidence interval [CI] -0.36, -0.04) and decreased the continuous performance task (CPT) reaction time (effect, -0.40, 95% CI -0.73, -0.07) in ADHD patients. The score for impulsive hyperactivity was slightly decreased (effect, -0.07, 95% CI -0.23, 0.09). Moreover, executive function was improved (effect, 0.71, 95% CI 0.37, 1.04). The capability of working memory appeared to be increased (effect, 0.48, 95% CI 0.21, 0.76) between the two groups. Visual appraisal of the sensitivity analysis suggested the absence of heterogeneity, and no obvious publication bias was detected. Discussion Based on the existing literature evidence, we conclude that digital therapy can be a promising therapeutic strategy for ADHD patients.
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Affiliation(s)
- Fan He
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yanjie Qi
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuanyue Zhou
- Department of Medical Psychology, The First Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Aihua Cao
- Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Xin Yue
- MaiDeHaiKe Technology, Beijing, China
| | - Shuanfeng Fang
- Children's Hospital Affiliated, Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Zheng
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
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Rodrigo-Yanguas M, Martín-Moratinos M, González-Tardón C, Sanchez-Sanchez F, Royuela A, Bella-Fernández M, Blasco-Fontecilla H. Effectiveness of a Personalized, Chess-Based Training Serious Video Game in the Treatment of Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder: Randomized Controlled Trial. JMIR Serious Games 2023; 11:e39874. [PMID: 37093628 PMCID: PMC10167585 DOI: 10.2196/39874] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 12/13/2022] [Accepted: 01/21/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Compared with traditional approaches, gaming strategies are promising interventions for the treatment of attention-deficit/hyperactivity disorder (ADHD). We developed a serious game, The Secret Trail of Moon (TSTM), for ADHD treatment. OBJECTIVE The main objective of this clinical trial was to demonstrate the effectiveness of an add-on, either TSTM or Therapeutic Chess (TC), in previously optimally drug-titrated, clinically stable patients with ADHD. METHODS This study is a prospective, unicentric, randomized clinical trial in clinically stable patients with ADHD, aged 12 to 22 years. The TSTM (n=35) and TC groups (n=34) performed 12 weekly sessions of their respective treatments. The control group (CG) patients (n=35) were called by phone every week, but they received no cognitive intervention. The primary end point was the change from baseline to end point in the parent "Behavior Rating Inventory of Executive Function-2" (BRIEF-2; patients' parents) in the per-protocol population (31 serious videogame: 24 TC and 34 CG). RESULTS Our study failed to probe clear-cut improvements in the global score of the BRIEF-2. However, the TC group showed improvements in measures of emotional control, emotional regulation, and inattention. The TSTM group showed improvements in measures of emotional regulation, inattention, and school context. CONCLUSIONS TSTM and TC did not improve executive function symptoms, but they improved ADHD symptomatology related to emotional regulation. Further studies with bigger samples are required to confirm these preliminary findings. TRIAL REGISTRATION ClinicalTrials.gov NCT04355065; https://clinicaltrials.gov/ct2/show/NCT04355065.
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Affiliation(s)
- María Rodrigo-Yanguas
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marina Martín-Moratinos
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | - Ana Royuela
- Biostatistics Unit, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
- Consorcio de Investigación Biomédica en Red: Epidemiología y Salud Pública, Madrid, Spain
| | - Marcos Bella-Fernández
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
- Departamento de Psicología, Universidad Pontificia de Comillas, Madrid, Spain
| | - Hilario Blasco-Fontecilla
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red: Salud Mental, Madrid, Spain
- Ita Mental Health, Madrid, Spain
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22
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Hong J, Su Y, Wang J, Xu X, Qu W, Fan H, Tan Y, Wang Z, Zhao Y, Tan S. Association between video gaming time and cognitive functions: A cross-sectional study of Chinese children and adolescents. Asian J Psychiatr 2023; 84:103584. [PMID: 37075676 DOI: 10.1016/j.ajp.2023.103584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/26/2023] [Accepted: 04/07/2023] [Indexed: 04/21/2023]
Abstract
This study sought to explore relationships between video gaming time and cognitive functioning in children and adolescents to provide a scientific reference for a reasonable time range of game use. A total of 649 participants aged 6-18 years were recruited through an online survey using convenience sampling. We used a combination of multiple linear regression models, smoothing splines, piecewise linear regression models, and log-likelihood ratio tests to comprehensively analyze the linear and nonlinear relationships between video gaming time and cognitive functions. Neurocognitive functioning was assessed using the digit symbol test, spatial span back test, Stroop task, and Wisconsin card sorting test. Facial and voice emotion recognition tests were used to evaluate social cognitive functioning. Video gaming time had a saturation effect on improving correct answers to the digit symbol test, which means that performance did not increase with increasing video gaming time when the video gaming duration reached 20 h/week (adjusted β = -0.58; 95% CI: -1.22, 0.05). Furthermore, both the relationship between video gaming time and the Wisconsin Card Sorting Test and the facial emotion recognition score showed a threshold effect. The completed categories of the Wisconsin Card Sorting Test began to decline after 17 h/week of playtime, and a decline in facial emotion recognition occurred after playing video games for over 20 h/week. These results suggest that children and adolescents should restrict their video gaming time to within a certain range, which could help reduce the negative effects of video games and retain their positive effects.
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Affiliation(s)
- Jiangyue Hong
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Yi Su
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Jinghan Wang
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Xuejing Xu
- Temple University, Philadelphia, Pennsylvania, 19122, USA
| | - Wei Qu
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Hongzhen Fan
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Yunlong Tan
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Zhiren Wang
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Yanli Zhao
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Shuping Tan
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China.
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23
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Nejati V, Derakhshan Z, Mohtasham A. The effect of comprehensive working memory training on executive functions and behavioral symptoms in children with attention deficit-hyperactivity disorder (ADHD). Asian J Psychiatr 2023; 81:103469. [PMID: 36669291 DOI: 10.1016/j.ajp.2023.103469] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
This study aimed to evaluate the effect of working memory training on executive functions and behavioral symptoms in children with ADHD. Thirty children with ADHD were randomly assigned to active control or Active Memory Intervention (AMIN) group. Executive functions and rating scales were used for assessment in three baseline, post-intervention, and 1-month follow-up sessions. The results show AMIN improves working memory and inhibitory control as well as ameliorates ADHD symptoms at home and school. Working memory training is beneficial and transferable intervention in children with ADHD.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Po box: 1983969411, Tehran, Islamic Republic of Iran.
| | - Zahra Derakhshan
- Department of Psychology, Shahid Beheshti University, Po box: 1983969411, Tehran, Islamic Republic of Iran
| | - Ahdiyeh Mohtasham
- Department of Psychology, Shahid Beheshti University, Po box: 1983969411, Tehran, Islamic Republic of Iran
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24
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Healey D, Milne B, Healey M. Adaption and implementation of the engage programme within the early childhood curriculum. Sci Rep 2022; 12:21580. [PMID: 36517624 PMCID: PMC9751130 DOI: 10.1038/s41598-022-25655-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
Poor self-regulation has been associated with an array of adverse outcomes including difficulties with school transition, educational attainment, and social functioning in childhood, and employment, mental health, physical health, relationships, and criminal activity in adulthood. Enhancing Neurobehavioural Gains with the Aid of Games and Exercises (ENGAGE) is a play-based intervention fostering the development of self-regulation in pre-schoolers and has led to improvements within the home setting. The aim for this study was to ascertain whether ENGAGE can be implemented within an Early Childhood Education (ECE) group setting and whether this leads to improved self-regulation. This trial has been registered with the Australian New Zealand Clinical Trials Registry (ANZCTR); trial number ACTRN12622000364774; trial web address: https://www.anzctr.org.au/ACTRN12622000364774.aspx . 668 children aged 3-5 years and their teachers, across 28 ECEs participated. Children's self-regulation skills were assessed via scores on the Hyperactivity, Aggression, and Attention Problems subscales of BASC-2. Results indicted no significant changes in self-regulation skills across a 10-week waitlist period. Following 10 weeks of the ENGAGE programme, significant improvements in self-regulation were reported, and these were maintained at 2- and 6-month follow-up. These findings indicate that ENGAGE translates well into the ECE setting and has the potential to have population-based impacts which could lead to more positive societal outcomes.
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Affiliation(s)
- Dione Healey
- grid.29980.3a0000 0004 1936 7830Department of Psychology, University of Otago, Box 56, Dunedin, 9054 New Zealand
| | - Barry Milne
- grid.9654.e0000 0004 0372 3343Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | - Matthew Healey
- Independant Consultant: Research Methods and Data Analyses, Dunedin, New Zealand
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25
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Nejati V, Fallah F, Raskin S. Inhibitory Control Training Improves Attention Deficit-Hyperactivity Disorder Symptoms and Externalizing Behavior. Clin Child Psychol Psychiatry 2022:13591045221144356. [PMID: 36474404 DOI: 10.1177/13591045221144356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Based on dysexecutive function theory of Attention deficit-hyperactivity disorder (ADHD), inhibitory control plays a crucial role in ADHD symptoms and respective behavioral problems. METHODS In the present study, 30 preschoolers with ADHD were recruited in a random clinical trial design in two control and intervention groups. The Flanker and Go/No-Go tasks, Swanson, Nolan, and Pelham Rating Scale, and Child Behavior Checklist were used for assessment at baseline, after the intervention, and 1-month follow-up sessions. The program for attentive rehabilitation of inhibition and selective attention (PARISA) was used for intervention in 10-12 sessions. RESULTS Findings showed an improvement in prepotent inhibition and interference control in the intervention group. Furthermore, the hyperactivity/impulsivity symptoms were ameliorated, and the externalizing behavioral problems were improved after the intervention. CONCLUSION Inhibitory control in preschoolers with ADHD is trainable, and the training gain could be transferred to ADHD symptoms and externalizing behavior.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, 48512Shahid Beheshti University, Tehran, Iran
| | - Fatemeh Fallah
- Department of Psychology, 68106Islamic Azad University, Tehran, Iran
| | - Sarah Raskin
- Department of Psychology, 8809Trinity College, Hartford, CT, USA
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26
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Lee S, Hill TR, Johnson B, Testa R, Priya V, Spencer-Smith M, Coghill D. Can Neurocognitive Outcomes Assist Measurement-Based Care for Children with Attention-Deficit/Hyperactivity Disorder? A Systematic Review and Meta-Analyses of the Relationships Among the Changes in Neurocognitive Functions and Clinical Outcomes of Attention-Deficit/Hyperactivity Disorder in Pharmacological and Cognitive Training Interventions. J Child Adolesc Psychopharmacol 2022; 32:250-277. [PMID: 35704876 DOI: 10.1089/cap.2022.0028] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental conditions among school-age children. Early intervention and ongoing evaluation of treatment effectiveness are essential to minimize the life-long negative impact of ADHD. Neurocognitive functions have been reported to improve with pharmacological and cognitive training interventions for children with ADHD. We evaluated the value of measuring change in neurocognitive functions following ADHD interventions as a treatment outcome. We systematically reviewed randomized control trials of two distinctive types of ADHD interventions-pharmacological treatments and cognitive training-and summarized the changes in neurocognitive and clinical outcomes using a series of meta-analyses. Both pharmacological and cognitive training interventions showed positive effects on some aspects of neurocognitive functions. However, there were no significant correlations between changes in neurocognitive function (e.g., inhibition) and changes in ADHD behavioral symptoms (e.g., impulsive behavior). Although the associations between changes in neurocognitive function and clinical outcomes are not well studied, based on current findings, it is not suitable to use change in neurocognitive outcomes as a proxy for change in ADHD clinical symptom-based outcomes. There is, however, notable value in monitoring changes in neurocognitive function associated with ADHD interventions to achieve the following aims: (1) understanding full treatment effect on children with ADHD, (2) identifying ancillary indicators of subclinical changes, and (3) provision of objective and less biased measures of treatment effects. These findings are important evidence that changes in neurocognitive function could be a co-occurring objective indication that parallels the clinical effects of ADHD treatments.
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Affiliation(s)
- Seungjae Lee
- Faculty of Medicine Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Thomas R Hill
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Beth Johnson
- Faculty of Medicine Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Renee Testa
- Faculty of Medicine Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Vishnu Priya
- Faculty of Medicine Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Megan Spencer-Smith
- Faculty of Medicine Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - David Coghill
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
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27
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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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28
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Chen S, Yu J, Zhang Q, Zhang J, Zhang Y, Wang J. Which Factor Is More Relevant to the Effectiveness of the Cognitive Intervention? A Meta-Analysis of Randomized Controlled Trials of Cognitive Training on Symptoms and Executive Function Behaviors of Children With Attention Deficit Hyperactivity Disorder. Front Psychol 2022; 12:810298. [PMID: 35095697 PMCID: PMC8792444 DOI: 10.3389/fpsyg.2021.810298] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate inattention, hyperactivity, and impulsivity. Multiple cognitive training appeared to be more effective than working memory training, but the evidence remains insufficient, particularly for the subgroup symptoms and executive function behaviors at home. Further analysis of the impact of factors on the effectiveness would facilitate the development of cognitive training. Methods: We searched PubMed, Cochrane Library, Psyche, Embase, Chinese Biomedical Literature Database, CNKI, and Weifang Database, and included randomized controlled trials (RCTs) of children with ADHD undergoing cognitive intervention. Metaanalysis and univariate metaregression were performed by STATE. The risk of bias was assessed with the Cochrane risk of bias tool 2.0 by the two investigators separately. This study was registered with INPLASY, number INPLASY202140065. Results: We included 17 RCTs in the systematic review, with a combined 1,075 participants. For metaanalyses of both subgroups of ADHD symptoms and the executive function behaviors, the test of published bias failed to reach the p < 0.05 level. When all of the training are considered together, cognitive training can improve the presentation of inattention symptoms [SMD = −0.390, 95%CI (−0.675, −0.104)] and executive function behaviors (SMD = −0.319, 95%CI (−0.527, −0.111)]. In the subgroup analysis, the effects of working memory training on both presentations were not statistically significant. In contrast, the multiple cognitive training had significant effects on the presentation of inattention symptoms [SMD = −0.507, 95% CI (−0.722, −0.292)], hyperactivity/impulsivity [SMD = −0.305, 95% CI (−0.518, −0.09)], and the executive function behaviors [SMD = −0.499, 95%CI (−0.707, −0.290)]. In addition, metaregression analysis showed that only training frequency did significantly impact the symptoms of ADHD and the executive function behaviors. Conclusion: This study showed that improvements in symptoms and executive function behaviors were related to the domains of cognitive intervention. The findings suggest that multiple domains of cognitive training and moderate training frequency may have wider clinical benefits. All the above results highlight further research in refining the executive functions of children with ADHD and developing individually tailored cognitive intervention on homes based for children with vulnerable executive functions. Systematic Review Registration: [http://inplasy.com/], [INPLASY202140065].
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Affiliation(s)
- Shuxian Chen
- Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Jinglong Yu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qiang Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jin Zhang
- The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ying Zhang
- Center for Evidence Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Junhong Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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29
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Larrivey V, Neva J, Finn K, Sikorskii A, Familiar-Lopez I, Ucheagwu V, Ezeamama A, Ruisenor-Escudero H, Nakasujja N, Boivin M, Giordani B. Daily Training efficiency during computerized cognitive rehabilitation training (CCRT): an analysis from a randomized trial in Ugandan children with and without severe malaria. Child Neuropsychol 2022; 28:197-211. [PMID: 34380364 PMCID: PMC8727492 DOI: 10.1080/09297049.2021.1962266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Children in Uganda are at risk for significant cognitive sequelae from severe malaria. Computerized cognitive rehabilitation training (CCRT) represents a potential method to improve working memory, behavior, and executive functioning, cognitive domains most at risk following severe malaria. The primary aim of this study was to complete a secondary analysis of data from a concluded CCRT randomized control trial in order to compare the training efficiency of a commonly used CCRT program under conditions of titrated (adaptive) or non-titrated (non-adaptive) training and with children with increasing malaria severity to determine how various factors may affect potential CCRT improvement. A total of 201 school-aged children (66.2% boys) who were either healthy (n = 102) or previously diagnosed with severe or cerebral malaria (n = 99) were randomized into two active treatment arms (titrated and non-titrated learning). Each child received 24 one-hour sessions of training over 8 weeks using Captain's Log® CCRT by BrainTrain, which includes a comprehensive set of CCRT tasks. Children generally benefited from CCRT over the 24 training sessions, but titrated CCRT showed a clear advantage over non-titrated. Severity of illness or factors such as BMI, did not moderate CCRT performance indicators. These findings support our hypothesis that titrated CCRT would result in steeper improvement in learning, but do not support our hypothesis that history of recent significant illness would affect learning proficiency. Findings were evident across all CCRT performance scores, even given that children were from generally rural, low-resource settings and were generally unfamiliar with computers.ABBREVIATIONS:Computerized Cognitive Rehabilitation Training (CCRT); Mental Processing Index (MPI); Home Observation for the Measurement of the Environment (HOME); Socioeconomic Status (SES); least square means (LSM).
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Affiliation(s)
| | | | | | - Alla Sikorskii
- Michigan State University, Global Neuropsychiatry Program
| | | | - Valentine Ucheagwu
- Departments of Psychiatry, Neurology, Psychology and School of Nursing, University of Michigan
| | - Amara Ezeamama
- Michigan State University, Global Neuropsychiatry Program
| | | | - Noeline Nakasujja
- Makerere School of Medicine; Madonna University, Nigeria, Okija Campus
| | - Michael Boivin
- University of Michigan,Michigan State University, Global Neuropsychiatry Program
| | - Bruno Giordani
- Departments of Psychiatry, Neurology, Psychology and School of Nursing, University of Michigan
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30
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Peñuelas-Calvo I, Jiang-Lin LK, Girela-Serrano B, Delgado-Gomez D, Navarro-Jimenez R, Baca-Garcia E, Porras-Segovia A. Video games for the assessment and treatment of attention-deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 2022; 31:5-20. [PMID: 32424511 DOI: 10.1007/s00787-020-01557-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/05/2020] [Indexed: 12/12/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and serious disorder among children. Video games have shown potential for aiding in child healthcare. Video games could contribute to the assessment and management of ADHD, but there are no previous reviews on this topic. Here, we systematically review the evidence about video game-based assessment tools and interventions for children diagnosed with ADHD. This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered in PROSPERO database. We searched four databases-PubMed, PsycInfo, Embase and clinicaltrials.gov-to identify original studies exploring either video game-based interventions or video game-based assessment tools in children with ADHD. After initial screening, full text revision and study selection, 22 articles were finally included in the review. Most studies used PC as platform, with a minority using a video console, pad, or 3D device. Video game-based assessment tools were generally effective in discriminating ADHD cases from controls, and in discriminating between ADHD subtypes. Video game-based therapeutic interventions were well accepted and generally effective in improving cognitive areas and decreasing ADHD symptoms. Gamification and cognitive training could be the main mechanisms underlying the usefulness and effectiveness of video game-based assessment tools and interventions. Software optimization and greater collaboration between developers and healthcare professionals are some of the priorities for future research in this area.
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Affiliation(s)
- Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. .,Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain. .,Department of Psychology, Universidad Complutense de Madrid, Madrid, Spain.
| | - Lin Ke Jiang-Lin
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Braulio Girela-Serrano
- Mood Instability Research Group, Centre for Psychiatry, Imperial College London, London, UK
| | | | - Rocio Navarro-Jimenez
- Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Enrique Baca-Garcia
- Department of Child and Adolescent Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain.,CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain.,Department of Psychiatry, Universidad Católica del Maule, Talca, Chile
| | - Alejandro Porras-Segovia
- Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
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31
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Society for Developmental and Behavioral Pediatrics Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents with Complex Attention-Deficit/Hyperactivity Disorder. J Dev Behav Pediatr 2021; 41 Suppl 2S:S35-S57. [PMID: 31996577 DOI: 10.1097/dbp.0000000000000770] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder and is associated with an array of coexisting conditions that complicate diagnostic assessment and treatment. ADHD and its coexisting conditions may impact function across multiple settings (home, school, peers, community), placing the affected child or adolescent at risk for adverse health and psychosocial outcomes in adulthood. Current practice guidelines focus on the treatment of ADHD in the primary care setting. The Society for Developmental and Behavioral Pediatrics has developed this practice guideline to facilitate integrated, interprofessional assessment and treatment of children and adolescents with "complex ADHD" defined by age (<4 years or presentation at age >12 years), presence of coexisting conditions, moderate to severe functional impairment, diagnostic uncertainty, or inadequate response to treatment.
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32
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Hardy KK, Berger C, Griffin D, Walsh KS, Sharkey CM, Weisman H, Gioia A, Packer RJ, Acosta MT. Computerized Working Memory Training for Children With Neurofibromatosis Type 1 (NF1): A Pilot Study. J Child Neurol 2021; 36:1078-1085. [PMID: 34472416 DOI: 10.1177/08830738211038083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The present study aimed to evaluate the feasibility and efficacy of CogmedRM, a computerized, home-based working memory (WM) training program, in children with NF1. METHOD A pre-post design was used to evaluate changes in performance-based measures of attention and WM, and parent-completed ratings of executive functioning. Children meeting eligibility criteria completed CogmedRM over 9 weeks. Primary outcomes included compliance statistics and change in attention and WM scores. RESULTS Thirty-one children (52% male; M age = 10.97 ± 2.51), aged 8-15, were screened for participation; 27 children (87%) evidenced WM difficulties and participated in CogmedRM training. On average, participants completed 19.7 out of 25 prescribed sessions, with an adherence rate of 69%. Participants demonstrated improvements in short-term memory, attention, and executive functioning (all Ps < .05). CONCLUSION Results suggest that computerized, home-based WM training programs may be both feasible and efficacious for children with NF1 and cognitive deficits.
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Affiliation(s)
- Kristina K Hardy
- Children's National Hospital, Washington, DC, USA.,Department of Pediatrics and Neurology, The George Washington University School of Medicine, Washington, DC, USA
| | - Carly Berger
- Children's National Hospital, Washington, DC, USA
| | | | - Karin S Walsh
- Children's National Hospital, Washington, DC, USA.,Department of Pediatrics and Neurology, The George Washington University School of Medicine, Washington, DC, USA
| | - Christina M Sharkey
- Children's National Hospital, Washington, DC, USA.,Department of Pediatrics and Neurology, The George Washington University School of Medicine, Washington, DC, USA
| | | | | | - Roger J Packer
- Children's National Hospital, Washington, DC, USA.,Department of Pediatrics and Neurology, The George Washington University School of Medicine, Washington, DC, USA
| | - Maria T Acosta
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
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33
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Bishop DVM. Using multiple outcomes in intervention studies: improving power while controlling type I errors. F1000Res 2021; 10:991. [PMID: 36925625 PMCID: PMC10011751 DOI: 10.12688/f1000research.73520.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
Background The CONSORT guidelines for clinical trials recommend use of a single primary outcome, to guard against the raised risk of false positive findings when multiple measures are considered. It is, however, possible to include a suite of multiple outcomes in an intervention study, while controlling the familywise error rate, if the criterion for rejecting the null hypothesis specifies that N or more of the outcomes reach an agreed level of statistical significance, where N depends on the total number of outcome measures included in the study, and the correlation between them. Methods Simulations were run, using a conventional null-hypothesis significance testing approach with alpha set at .05, to explore the case when between 2 and 12 outcome measures are included to compare two groups, with average correlation between measures ranging from zero to .8, and true effect size ranging from 0 to .7. In step 1, a table is created giving the minimum N significant outcomes (MinNSig) that is required for a given set of outcome measures to control the familywise error rate at 5%. In step 2, data are simulated using MinNSig values for each set of correlated outcomes and the resulting proportion of significant results is computed for different sample sizes,correlations, and effect sizes. Results The Adjust NVar approach can achieve a more efficient trade-off between power and type I error rate than use of a single outcome when there are three or more moderately intercorrelated outcome variables. Conclusions Where it is feasible to have a suite of moderately correlated outcome measures, then this might be a more efficient approach than reliance on a single primary outcome measure in an intervention study. In effect, it builds in an internal replication to the study. This approach can also be used to evaluate published intervention studies.
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Affiliation(s)
- Dorothy V. M. Bishop
- Department of Experimental Psychology, University of Oxford, Oxford, Oxon, OX2 6GG, UK
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Wexler BE, Vitulano LA, Moore C, Katsovich L, Smith SD, Rush C, Grantz H, Dong J, Leckman JF. An integrated program of computer-presented and physical cognitive training exercises for children with attention-deficit/hyperactivity disorder. Psychol Med 2021; 51:1524-1535. [PMID: 32090720 DOI: 10.1017/s0033291720000288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND This study integrated an experimental medicine approach and a randomized cross-over clinical trial design following CONSORT recommendations to evaluate a cognitive training (CT) intervention for attention deficit hyperactivity disorder (ADHD). The experimental medicine approach was adopted because of documented pathophysiological heterogeneity within the diagnosis of ADHD. The cross-over design was adopted to provide the intervention for all participants and make maximum use of data. METHODS Children (n = 93, mean age 7.3 +/- 1.1 years) with or sub-threshold for ADHD were randomly assigned to CT exercises over 15 weeks, before or after 15 weeks of treatment-as-usual (TAU). Fifteen dropped out of the CT/TAU group and 12 out of the TAU/CT group, leaving 66 for cross-over analysis. Seven in the CT/TAU group completed CT before dropping out making 73 available for experimental medicine analyses. Attention, response inhibition, and working memory were assessed before and after CT and TAU. RESULTS Children were more likely to improve with CT than TAU (27/66 v. 13/66, McNemar p = 0.02). Consistent with the experimental medicine hypotheses, responders improved on all tests of executive function (p = 0.009-0.01) while non-responders improved on none (p = 0.27-0.81). The degree of clinical improvement was predicted by baseline and change scores in focused attention and working memory (p = 0.008). The response rate was higher in inattentive and combined subtypes than hyperactive-impulsive subtype (p = 0.003). CONCLUSIONS Targeting cognitive dysfunction decreases clinical symptoms in proportion to improvement in cognition. Inattentive and combined subtypes were more likely to respond, consistent with targeted pathology and clinically relevant heterogeneity within ADHD.
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Affiliation(s)
- Bruce E Wexler
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Christina Moore
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Department of Psychology, University of Delaware, Newark, DE, USA
| | | | - Stephanie D Smith
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Cindy Rush
- Department of Statistics, Columbia University, New York, NY, USA
| | - Heidi Grantz
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | | | - James F Leckman
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Harnessing Wise Interventions to Advance the Potency and Reach of Youth Mental Health Services. Clin Child Fam Psychol Rev 2021; 23:70-101. [PMID: 31440858 DOI: 10.1007/s10567-019-00301-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite progress in research on evidence-based treatments (EBTs) for youth psychopathology, many youths with mental health needs do not receive services, and EBTs are not always effective for those who access them. Wise interventions (WIs) may help address needs for more disseminable, potent youth mental health interventions. WIs are single-component, social-psychological interventions designed to foster adaptive meaning-making. They have improved health-related and interpersonal youth outcomes, yet their potential to reduce youth psychopathology has not been systematically explored. Accordingly, we conducted a systematic, descriptive review characterizing WIs' potential to reduce youth mental health problems. Across 25 RCTs (N = 9219 youths, ages 11-19) testing 13 intervention types, 7 WIs qualified as "Well-Established," "Probably Efficacious," or "Possibly Efficacious" for reducing one or more types of youth psychopathology, relative to controls. Among these, 5 WIs significantly reduced youth depressive symptoms; 3, general psychological distress; and 1 each, eating problems, anxiety, and substance use. Three of these 7 WIs were self-administered by youths, and four by trained interventionists; collectively, they were 30-168 min in length and targeted clinic-referred and non-referred samples in clinical, school, and laboratory settings. Overall, certain WIs show promise in reducing mild-to-severe youth psychopathology. Given their brevity and low cost relative to traditional (i.e., therapist-delivered, 12- to 16-week, clinic-based) EBTs, WIs may represent beneficial additions to the youth mental healthcare ecosystem. Priorities for future research are proposed, including testing WIs for parents, younger children, and externalizing problems; as EBT adjuncts; and in schools and primary care clinics to increase access to brief, effective supports.
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Bharadwaj SV, Yeatts P, Headley J. Efficacy of cogmed working memory training program in improving working memory in school-age children with and without neurological insults or disorders: A meta-analysis. APPLIED NEUROPSYCHOLOGY-CHILD 2021; 11:891-903. [PMID: 34085876 DOI: 10.1080/21622965.2021.1920943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This meta-analysis assessed the efficacy of the Cogmed Working Memory Training program in improving near-transfer measures (verbal and visuospatial working memory) and far-transfer measures (attention, executive function, and academic achievement) in school-age children with and without neurological insults or disorders. Relevant studies were searched in databases and clinical trial registries using the keyword Cogmed. Ten published studies and unpublished data from one study met the inclusion criteria. Hedges g was calculated for each outcome measure obtained at pre-intervention, post-intervention, and 3-6 month time points. Analysis compared outcome measures in the control versus experimental groups and examined the role of moderators on treatment effects (control group intervention, intervention environment). Data revealed significant medium-size effects of the Cogmed program in improving verbal and visuospatial working memory post-intervention and for verbal working memory only at the 3-6 month time point. However, the training did not generalize to the far-transfer measures. Analyses indicated that only the type of intervention provided for the control group moderated treatment effects on verbal and visual working memory. Meta-analytic findings suggest that the Cogmed program leads to short-term improvements and in some cases, long-term improvements in working memory in school-age children; however, these effects may not generalize to far-transfer measures.
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Affiliation(s)
- Sneha V Bharadwaj
- Department of Communication Sciences and Oral Health, Texas Woman's University, Denton, Texas, USA
| | - Paul Yeatts
- Center for Research Design & Analysis, Office of Research and Sponsored Programs, Texas Woman's University, Denton, Texas, USA
| | - Johnna Headley
- Department of Communication Sciences and Oral Health, Texas Woman's University, Denton, Texas, USA
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Nejati V. Program for attention rehabilitation and strengthening (PARS) improves executive functions in children with attention deficit- hyperactivity disorder (ADHD). RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103937. [PMID: 33756252 DOI: 10.1016/j.ridd.2021.103937] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/21/2020] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
Attention is improved through cognitive rehabilitation. The purpose of the present study was the evaluation of the effect of a paper and pencil program for attention rehabilitation and strengthening (PARS) in children with ADHD. Thirty children with ADHD were randomly divided into two equal intervention and control groups. The intervention group received 12-15 sessions of intervention through PARS. Sustained, selective, and shifting attention, inhibitory control, and working memory were assessed by Persian attention registration, Stroop, color trail making, Go/No-Go, and 1- back tests. Analyses indicated that the experimental group, in comparison with the control group, showed improved selective and sustained attention and the training effects transfers to executive functions, inhibitory control and working memory. The result is discussed in the light of transferability of training effects from attention to executive functions.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, PO Box: 1983969411, Tehran, Iran.
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Hocking MC, Walsh KS, Hardy KK, Conklin HM. Addressing Neurocognitive Late Effects in Pediatric Cancer Survivors: Current Approaches and Future Opportunities. J Clin Oncol 2021; 39:1824-1832. [PMID: 33886353 DOI: 10.1200/jco.20.02327] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Matthew C Hocking
- The Children's Hospital of Philadelphia, Philadelphia, PA.,The University of Pennsylvania, Philadelphia, PA
| | - Karin S Walsh
- Children's National Hospital, Washington, DC.,The George Washington University School of Medicine, Washington, DC
| | - Kristina K Hardy
- Children's National Hospital, Washington, DC.,The George Washington University School of Medicine, Washington, DC
| | - Heather M Conklin
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN
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Søndergaard Knudsen HB, Jensen de López KM. Face-to-face workin g memory training does not enhance children’s reading comprehension - a pilot study with Danish children1. NORDIC PSYCHOLOGY 2021. [DOI: 10.1080/19012276.2020.1856001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Di Lieto MC, Pecini C, Brovedani P, Sgandurra G, Dell'Omo M, Chilosi AM, Guzzetta A, Perazza S, Sicola E, Cioni G. Adaptive Working Memory Training Can Improve Executive Functioning and Visuo-Spatial Skills in Children With Pre-term Spastic Diplegia. Front Neurol 2021; 11:601148. [PMID: 33551960 PMCID: PMC7854548 DOI: 10.3389/fneur.2020.601148] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/27/2020] [Indexed: 12/03/2022] Open
Abstract
Pre-term spastic diplegia (pSD) due to periventricular leukomalacia is a form of cerebral palsy in which weaknesses in executive functions are reported beyond the core visuo-spatial deficits. The study aimed at improving executive functioning and visuo-spatial skills with an evidence-based training focused on working memory in children with pSD. The intervention study followed a stepped wedge design. 19 children with pSD (11 female and 8 male; age range: 4;1–13;1 years), mild to moderate upper limb impairment and Verbal Intelligence Quotient (VIQ) >80 participated to the study. The children were trained with a home-based adaptive working memory training (CogMed®) over a 5-week period. The primary outcome measure was the CogMed Improvement index; pre- and post-test explorative neuropsychological assessment was conducted with a subset of tests from the NEPSY-II battery. Working memory training in children with pSD significantly improved trained working memory abilities (CogMed indices) as well as non-trained skills, such as visuo-spatial skills, inhibition of automatic responses and phonological processing. The results suggest that standard rehabilitation schedules for children with pSD should be integrated with trainings on executive functions.
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Affiliation(s)
- Maria Chiara Di Lieto
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Chiara Pecini
- Department of Education, Language, Interculture and Psychology, University of Florence, Florence, Italy
| | - Paola Brovedani
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marta Dell'Omo
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Anna Maria Chilosi
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Silvia Perazza
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Elisa Sicola
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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de Oliveira Rosa V, Moreira-Maia CR, Wagner F, Simioni A, de Fraga Bassotto C, Moritz GR, Schmitz M, Rohde LAP. Computerized Cognitive Training for ADHD as an Add-On Treatment to Stimulants: A Randomized Clinical Trial. J Atten Disord 2021; 25:275-285. [PMID: 30547696 DOI: 10.1177/1087054718816818] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: Computerized cognitive training (CCT) as add-on treatment to stimulants for ADHD core symptoms is scarcely investigated. The purpose of this study is to assess the effect of CCT in a randomized controlled clinical trial for ADHD in children and adolescents treated with stimulants. Method: Fifty-three participants aged 6 to 13 years receiving stimulant treatment and presenting ADHD residual symptoms were randomized either to a CCT (n = 29) or to a controlled nonactive condition (n = 24) for four sessions/week during 12 weeks. The main outcome measure was inattentive symptoms assessed using the Swanson, Nolan, and Pelham-IV (SNAP-IV) Scale. Secondary outcomes include, among others, hyperactive/impulsive symptoms and cognitive tests. Results: There were neither significant group differences on ADHD-inattentive symptoms after the intervention nor on both ADHD-hyperactivity/impulsivity symptoms and cognitive measures. Conclusion: Our study does not provide evidence for the benefits of cognitive training over nonactive training on core ADHD symptoms in medicated ADHD children and adolescents.
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Affiliation(s)
| | | | - Flávia Wagner
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - André Simioni
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Marcelo Schmitz
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luis Augusto Paim Rohde
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
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Spencer-Smith M, Quach J, Mensah F, Roberts G, Gathercole S, Wake M, Anderson PJ. The Effectiveness of Working Memory Training for Children With Low Working Memory. Pediatrics 2020; 146:peds.2019-4028. [PMID: 33159002 DOI: 10.1542/peds.2019-4028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Subgroups of children may benefit more from working memory training than others. In this study, we aimed to examine whether response to the Cogmed Working Memory Training program differed for children with low IQ and elevated attention-deficit/hyperactivity disorder, emotional and behavioral symptoms, special health care needs, or by sex. METHODS We used data from the Memory Maestros trial, a population-based randomized controlled trial of the Cogmed program delivered at school (n = 226) compared to usual teaching (n = 226) in grade 1 children (mean age 6.9 years; SD 0.4) with low working memory. Cogmed comprises 20 to 25 sessions of 45-minute duration over 5 to 7 weeks. Children completed subtests from the Automated Working Memory Assessment to measure change in working memory from baseline to 6 months postrandomization. RESULTS After training, improved working memory standard scores (>1 SD) from baseline to 6 months were observed for approximately one-third of the children, with more than half maintaining stable scores (within 1 SD). However, similar outcomes were observed for children receiving usual teaching. Differential effect of Cogmed versus usual teaching was evident for children with elevated hyperactivity and/or inattention, who were less likely to show improved visuospatial working memory, but not for other subgroups studied. CONCLUSIONS Children with elevated hyperactivity and/or inattention were less likely to show clinically meaningful improvement after Cogmed; however, differential effects were not evident for children with low IQ and elevated emotional and behavioral symptoms, special health care needs, or by sex. More research is needed to determine if training can improve working memory and, if so, for whom.
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Affiliation(s)
- Megan Spencer-Smith
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; .,Clinical Sciences Theme
| | - Jon Quach
- Population Health Theme, and.,Melbourne Graduate School of Education, The University of Melbourne, Carlton, Victoria, Australia
| | - Fiona Mensah
- Population Health Theme, and.,Department of Paediatrics and
| | - Gehan Roberts
- Population Health Theme, and.,Centre for Community Child Health, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics and
| | - Susan Gathercole
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom; and
| | - Melissa Wake
- Population Health Theme, and.,Department of Paediatrics and.,Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Clinical Sciences Theme
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Computer-based inhibitory control training in children with Attention-Deficit/Hyperactivity Disorder (ADHD): Evidence for behavioral and neural impact. PLoS One 2020; 15:e0241352. [PMID: 33253237 PMCID: PMC7703966 DOI: 10.1371/journal.pone.0241352] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/14/2020] [Indexed: 12/21/2022] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychological disorder of childhood. Medication and cognitive behavioral therapy are effective treatments for many children; however, adherence to medication and therapy regimens is low. Thus, identifying effective adjunct treatments is imperative. Previous studies exploring computerized training programs as supplementary treatments have targeted working memory or attention. However, many lines of research suggest inhibitory control (IC) plays a central role in ADHD pathophysiology, which makes IC a potential intervention target. In this randomized control trial (NCT03363568), we target IC using a modified stop-signal task (SST) training designed by NeuroScouting, LLC in 40 children with ADHD, aged 8 to 11 years. Children were randomly assigned to adaptive treatment (n = 20) or non-adaptive control (n = 20) with identical stimuli and task goals. Children trained at home for at least 5 days a week (about 15m/day) for 4-weeks. Relative to the control group, the treatment group showed decreased relative theta power in resting EEG and trending improvements in parent ratings of attention (i.e. decreases in inattentive behaviors). Both groups showed improved SST performance. There was not evidence for treatment effects on hyperactivity or teacher ratings of symptoms. Results suggest training IC alone has potential to positively impact symptoms of ADHD and provide evidence for neural underpinnings of this impact (change in theta power; change in N200 latency). This shows promising initial results for the use of computerized training of IC in children with ADHD as a potential adjunct treatment option for children with ADHD.
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Sullivan JA, Dumont JR, Memar S, Skirzewski M, Wan J, Mofrad MH, Ansari HZ, Li Y, Muller L, Prado VF, Prado MAM, Saksida LM, Bussey TJ. New frontiers in translational research: Touchscreens, open science, and the mouse translational research accelerator platform. GENES BRAIN AND BEHAVIOR 2020; 20:e12705. [PMID: 33009724 DOI: 10.1111/gbb.12705] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/03/2020] [Accepted: 09/29/2020] [Indexed: 12/18/2022]
Abstract
Many neurodegenerative and neuropsychiatric diseases and other brain disorders are accompanied by impairments in high-level cognitive functions including memory, attention, motivation, and decision-making. Despite several decades of extensive research, neuroscience is little closer to discovering new treatments. Key impediments include the absence of validated and robust cognitive assessment tools for facilitating translation from animal models to humans. In this review, we describe a state-of-the-art platform poised to overcome these impediments and improve the success of translational research, the Mouse Translational Research Accelerator Platform (MouseTRAP), which is centered on the touchscreen cognitive testing system for rodents. It integrates touchscreen-based tests of high-level cognitive assessment with state-of-the art neurotechnology to record and manipulate molecular and circuit level activity in vivo in animal models during human-relevant cognitive performance. The platform also is integrated with two Open Science platforms designed to facilitate knowledge and data-sharing practices within the rodent touchscreen community, touchscreencognition.org and mousebytes.ca. Touchscreencognition.org includes the Wall, showcasing touchscreen news and publications, the Forum, for community discussion, and Training, which includes courses, videos, SOPs, and symposia. To get started, interested researchers simply create user accounts. We describe the origins of the touchscreen testing system, the novel lines of research it has facilitated, and its increasingly widespread use in translational research, which is attributable in part to knowledge-sharing efforts over the past decade. We then identify the unique features of MouseTRAP that stand to potentially revolutionize translational research, and describe new initiatives to partner with similar platforms such as McGill's M3 platform (m3platform.org).
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Affiliation(s)
- Jacqueline A Sullivan
- Department of Philosophy, The University of Western Ontario, Ontario, Canada.,Rotman Institute of Philosophy, The University of Western Ontario, Ontario, Canada.,Brain and Mind Institute, The University of Western Ontario, Ontario, Canada
| | - Julie R Dumont
- BrainsCAN, The University of Western Ontario, Ontario, Canada.,Robarts Research Institute, The University of Western Ontario, Ontario, Canada
| | - Sara Memar
- Robarts Research Institute, The University of Western Ontario, Ontario, Canada
| | - Miguel Skirzewski
- BrainsCAN, The University of Western Ontario, Ontario, Canada.,Robarts Research Institute, The University of Western Ontario, Ontario, Canada
| | - Jinxia Wan
- Division of Sciences, State Key Laboratory of Membrane Biology, Peking University School of Life Sciences, Beijing, China.,PKU-IDG/McGovern Institute for Brain Research, Beijing, China
| | - Maryam H Mofrad
- Brain and Mind Institute, The University of Western Ontario, Ontario, Canada.,Department of Applied Mathematics, The University of Western Ontario, Ontario, Canada
| | | | - Yulong Li
- Division of Sciences, State Key Laboratory of Membrane Biology, Peking University School of Life Sciences, Beijing, China.,PKU-IDG/McGovern Institute for Brain Research, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Lyle Muller
- Brain and Mind Institute, The University of Western Ontario, Ontario, Canada.,Department of Applied Mathematics, The University of Western Ontario, Ontario, Canada
| | - Vania F Prado
- Robarts Research Institute, The University of Western Ontario, Ontario, Canada.,Department of Anatomy and Cell Biology, The University of Western Ontario, Ontario, Canada.,Department of Physiology and Pharmacology, The University of Western Ontario, Ontario, Canada
| | - Marco A M Prado
- Robarts Research Institute, The University of Western Ontario, Ontario, Canada.,Department of Anatomy and Cell Biology, The University of Western Ontario, Ontario, Canada.,Department of Physiology and Pharmacology, The University of Western Ontario, Ontario, Canada
| | - Lisa M Saksida
- Brain and Mind Institute, The University of Western Ontario, Ontario, Canada.,BrainsCAN, The University of Western Ontario, Ontario, Canada.,Robarts Research Institute, The University of Western Ontario, Ontario, Canada.,Department of Physiology and Pharmacology, The University of Western Ontario, Ontario, Canada
| | - Timothy J Bussey
- Brain and Mind Institute, The University of Western Ontario, Ontario, Canada.,BrainsCAN, The University of Western Ontario, Ontario, Canada.,Robarts Research Institute, The University of Western Ontario, Ontario, Canada.,Department of Physiology and Pharmacology, The University of Western Ontario, Ontario, Canada.,Department of Psychiatry, The University of Western Ontario, Ontario, Canada
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Van Pelt AE, Lipow MI, Scott JC, Lowenthal ED. Interventions for Children with Neurocognitive Impairments in Resource-Limited Settings: A Systematic Review. CHILDREN AND YOUTH SERVICES REVIEW 2020; 118:105393. [PMID: 32968334 PMCID: PMC7505233 DOI: 10.1016/j.childyouth.2020.105393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Many children and adolescents around the world suffer from neurocognitive deficits due to chronic disorders, such as Human Immunodeficiency Virus (HIV) and malaria. Resource-limited settings exacerbate the risk of negative cognitive outcomes due to high prevalence of associated disorders, poverty, and limited access to interventions. Current literature does not provide consensus regarding the efficacy of interventions to support children with cognitive impairments in low-resource settings. This research aimed to identify and evaluate interventions for youth with neurocognitive deficits in resource-limited settings. A systematic review of peer-reviewed literature was conducted within five databases (PubMed, Web of Science, CINAHL, PsycInfo, and WHO Index Medicus). Cognitive impairment was broadly defined to be inclusive of aspects of intellectual and cognitive functioning (e.g., working memory, attention, executive function). The income status of the country or countries in which each study was located was determined according to World Bank Income Status. Studies conducted in countries classified as low- or middle-income were included. Since low-resource areas exist within high-income countries, the resource availability within study settings in high-income countries was systematically evaluated for inclusion. The search yielded 19 articles that met all inclusion criteria. Interventions included strategies involving caregiver training, computerized and non-computerized cognitive training, physical activity, and nutritional supplementation. Interventions were administered in medical facilities, educational facilities, or the home. The majority of the interventions targeted the domains of memory and attention. Overall, the efficacy of interventions was inconsistent. Further, results indicated that the relationship between cognitive improvement and intervention types was not consistent across cognitive domains. However, when evaluating studies on an individual basis, some strategies demonstrated clinically- and statistically-significant improvement in cognitive function among specific groups of children. The low article yield highlights that few researchers have evaluated pediatric cognitive support interventions in low-resource contexts. This review suggests support strategies that should be considered for future studies as neurocognitive screening capacity improves in resource-limited settings.
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Affiliation(s)
- Amelia E. Van Pelt
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, 423 Guardian Drive, Philadelphia, Pennsylvania, United States 19104-6021
- Department of Pediatrics (Global Health Center), Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 3501 Civic Center Blvd, Philadelphia, Pennsylvania, United States 19104
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3461 Locust Walk, Philadelphia, Pennsylvania, United States 19104-6218
| | - Matthew I. Lipow
- Department of Pediatrics (Global Health Center), Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 3501 Civic Center Blvd, Philadelphia, Pennsylvania, United States 19104
- Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, Pennsylvania, United States 19129
| | - J. Cobb Scott
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Richards Building, 5th Floor, 3700 Hamilton Walk, Philadelphia, Pennsylvania, 19104-6085 United States
- VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, 3900 Woodland Ave, MC116, Philadelphia, PA, 19104, United States
| | - Elizabeth D. Lowenthal
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, 423 Guardian Drive, Philadelphia, Pennsylvania, United States 19104-6021
- Department of Pediatrics (Global Health Center), Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 3501 Civic Center Blvd, Philadelphia, Pennsylvania, United States 19104
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Rossignoli-Palomeque T, Perez-Hernandez E, González-Marqués J. Training effects of attention and EF strategy-based training "Nexxo" in school-age students. Acta Psychol (Amst) 2020; 210:103174. [PMID: 32919092 DOI: 10.1016/j.actpsy.2020.103174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 08/14/2020] [Accepted: 08/25/2020] [Indexed: 11/29/2022] Open
Abstract
Given the importance of attention and executive functions in children's behavior, programs directed to improve these processes are of interest. Nexxo-training combines the use of the Nexxo touchscreen application (go/no-go and stop signal tasks) with procedural metacognitive strategies. The present paper reports a test of Nexxo's impact on children aged 6-7 and 8-9 years. We conducted a randomized active-controlled trial involving 108 typically-developing children: 1st grade (N = 61, M = 6.46 years, SD = 0.35) and 3rd grade (N = 47, M = 8.5 years, SD = 0.27), randomly assigned to: (1) experimental, (2) active-control, or (3) passive-control groups. A 2-month follow-up was carried out after the intervention. The 3rd grade experimental group displayed a significant reduction in attentional problems at follow-up compared to both control groups. Executive Function problems were also reduced at follow-up in the experimental group. Participants in this group improved in Supervision (self-monitoring) at post-intervention and follow-up compared to passive-controls. Although group effect was not significant at t1, it was significant at post measures in experimental group compared to passive-controls. Nexxo-training revealed a trend-level improvement in attention and executive functions for children in the 3rd grade.
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Affiliation(s)
| | - E Perez-Hernandez
- Department of Development and Educational Psychology, Autonomous University of Madrid, Madrid, Spain
| | - J González-Marqués
- Department of Basic Psychology II, Complutense University of Madrid, Madrid, Spain
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Scott H, Harvey DJ, Li Y, McLennan YA, Johnston CK, Shickman R, Piven J, Schweitzer JB, Hessl D. Cognitive Training Deep Dive: The Impact of Child, Training Behavior and Environmental Factors within a Controlled Trial of Cogmed for Fragile X Syndrome. Brain Sci 2020; 10:brainsci10100671. [PMID: 32992879 PMCID: PMC7601580 DOI: 10.3390/brainsci10100671] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 09/20/2020] [Accepted: 09/23/2020] [Indexed: 11/21/2022] Open
Abstract
Children with fragile X syndrome (FXS) exhibit deficits in a variety of cognitive processes within the executive function domain. As working memory (WM) is known to support a wide range of cognitive, learning and adaptive functions, WM computer-based training programs have the potential to benefit people with FXS and other forms of intellectual and developmental disability (IDD). However, research on the effectiveness of WM training has been mixed. The current study is a follow-up “deep dive” into the data collected during a randomized controlled trial of Cogmed (Stockholm, Sweden) WM training in children with FXS. Analyses characterized the training data, identified training quality metrics, and identified subgroups of participants with similar training patterns. Child, parent, home environment and training quality metrics were explored in relation to the clinical outcomes during the WM training intervention. Baseline cognitive level and training behavior metrics were linked to gains in WM performance-based assessments and also to reductions in inattention and other behaviors related to executive functioning during the intervention. The results also support a recommendation that future cognitive intervention trials with individuals with IDD such as FXS include additional screening of participants to determine not only baseline feasibility, but also capacity for training progress over a short period prior to inclusion and randomization. This practice may also better identify individuals with IDD who are more likely to benefit from cognitive training in clinical and educational settings.
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Affiliation(s)
- Haleigh Scott
- MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (H.S.); (Y.A.M.); (C.K.J.); (R.S.); (J.B.S.)
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Danielle J. Harvey
- Division of Biostatistics, Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA 95616, USA; (D.J.H.); (Y.L.)
| | - Yueju Li
- Division of Biostatistics, Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA 95616, USA; (D.J.H.); (Y.L.)
| | - Yingratana A. McLennan
- MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (H.S.); (Y.A.M.); (C.K.J.); (R.S.); (J.B.S.)
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Cindy K. Johnston
- MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (H.S.); (Y.A.M.); (C.K.J.); (R.S.); (J.B.S.)
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Ryan Shickman
- MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (H.S.); (Y.A.M.); (C.K.J.); (R.S.); (J.B.S.)
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Julie B. Schweitzer
- MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (H.S.); (Y.A.M.); (C.K.J.); (R.S.); (J.B.S.)
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - David Hessl
- MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (H.S.); (Y.A.M.); (C.K.J.); (R.S.); (J.B.S.)
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA 95817, USA
- Correspondence: ; Tel.: +1-916-703-0249
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48
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Liberta TA, Kagiwada M, Ho K, Spat-Lemus J, Voelbel G, Kohn A, Perrine K, Josephs L, McLean EA, Sacks-Zimmerman A. An investigation of Cogmed working memory training for neurological surgery patients. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2020.100786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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49
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Do Working Memory Deficits Underlie Reading Problems in Attention-Deficit/Hyperactivity Disorder (ADHD)? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:433-446. [PMID: 29923160 DOI: 10.1007/s10802-018-0447-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Reading problems are common in children with ADHD and show strong covariation with these children's underdeveloped working memory abilities. In contrast, working memory training does not appear to improve reading performance for children with ADHD or neurotypical children. The current study bridges the gap between these conflicting findings, and combines dual-task methodology with Bayesian modeling to examine the role of working memory for explaining ADHD-related reading problems. Children ages 8-13 (M = 10.50, SD = 1.59) with and without ADHD (N = 78; 29 girls; 63% Caucasian/Non-Hispanic) completed a counterbalanced series of reading tasks that systematically manipulated concurrent working memory demands. Adding working memory demands produced disproportionate decrements in reading comprehension for children with ADHD (d = -0.67) relative to Non-ADHD children (d = -0.18); comprehension was significantly reduced in both groups when working memory demands were increased. These effects were robust to controls for foundational reading skills (decoding, sight word vocabulary) and comorbid reading disability. Concurrent working memory demands did not slow reading speed for either group. The ADHD group showed lower comprehension (d = 1.02) and speed (d = 0.69) even before adding working memory demands beyond those inherently required for reading. Exploratory conditional effects analyses indicated that underdeveloped working memory overlapped with 41% (comprehension) and 85% (speed) of these between-group differences. Reading problems in ADHD appear attributable, at least in part, to their underdeveloped working memory abilities. Combined with prior cross-sectional and longitudinal findings, the current experimental evidence positions working memory as a potential causal mechanism that is necessary but not sufficient for effectively understanding written language.
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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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