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Parker AJ, Walker JC, Jordan LS, Takarae Y, Wiggins JL, Dougherty LR. Neural mechanisms of inhibitory control in preadolescent irritability: Insights from the ABCD study. Biol Psychol 2024; 192:108856. [PMID: 39154835 DOI: 10.1016/j.biopsycho.2024.108856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/19/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVE Elevated pediatric irritability is a transdiagnostic symptom that predicts multiple mental health problems in adolescence and adulthood. Altered top-down regulatory networks, such as inhibitory control networks that suppress an impulse in favor of goal-directed behavior, are thought to contribute to high levels of youth irritability. Nevertheless, little work has examined links between youth irritability and neural processes supporting inhibitory control in large diverse samples, nor have they focused on the key period ramping up to adolescence (i.e., preadolescence). METHOD Functional MRI data from 5380 preadolescents (age M=9.97 years, SD=0.62) in the baseline Adolescent Brain and Cognitive Development (ABCD) Study were analyzed. Parents reported on their preadolescent's irritability. The stop signal task (SST) was leveraged to probe successful and failed inhibitory control. Activation and functional connectivity with amygdala, ventral striatum, and prefrontal seed regions were calculated during the SST and used in whole brain and region of interest (ROI) group-level analyses evaluating irritability effects. RESULTS Preadolescents with higher levels of irritability displayed decreases in functional connectivity among amygdala, ventral striatum, and prefrontal cortex regions during both successful and failed inhibitory control conditions. These results remained after adjusting for co-occurring anxiety, depression, and attention-deficit/hyperactivity symptoms. CONCLUSIONS Findings suggest neural aberrations in inhibitory control play a role in the pathophysiology of preadolescent irritability and associations are not merely due to co-occurring symptoms. Neural mechanisms of inhibitory control associated with irritability may provide novel intervention targets.
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Affiliation(s)
- Alyssa J Parker
- Department of Psychology, University of Maryland, College Park, United States.
| | - Johanna C Walker
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, United States
| | - Leslie S Jordan
- Department of Psychology, University of Maryland, College Park, United States; Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, United States; Institute for Clinical & Translational Research (ICTR), University of Maryland Baltimore, United States
| | - Yukari Takarae
- Department of Psychology, San Diego State University, United States
| | - Jillian Lee Wiggins
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, United States; Department of Psychology, San Diego State University, United States
| | - Lea R Dougherty
- Department of Psychology, University of Maryland, College Park, United States
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Nadermohammadi Moghadam M, Bakhshi P, Azarkollah A, Moulai B, Molavi P. A Comparison of Effectiveness of Attention Process Training (APT) with Parenting Management Training (PMT) in Reducing Symptoms of Attention Deficit Hyperactivity Disorder. IRANIAN JOURNAL OF PSYCHIATRY 2024; 19:254-264. [PMID: 39055521 PMCID: PMC11267122 DOI: 10.18502/ijps.v19i3.15802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 03/09/2024] [Accepted: 05/26/2024] [Indexed: 07/27/2024]
Abstract
Objective: Child-oriented psychotherapies, such as Attention Process Training (APT), target ADHD symptoms directly, whereas family-oriented interventions, like Parent Management Training (PMT), address its functional impairments. The aim of this study was to compare the effectiveness of APT and PMT in treating ADHD symptoms. Method : This research was a randomized controlled trial in which 45 children (26 females and 19 males, with a mean age of 8.47 ± 1.66 years) with ADHD were selected conveniently and assigned randomly to one of three groups (PMT = 15, APT = 15, and CTRL = 15). The groups had no significant differences in ADHD severity. The PMT children were managed with parenting techniques. Children in the APT group practiced attention techniques, while children in the control group did not receive any intervention. Ritalin was prescribed to all the children in the three groups. The score on the Conners Parenting Rating Scale-Revised: Short form was the outcome variable. Results: Both interventions decreased ADHD symptoms severity more than the control group. Howver, the reduction in the APT group was more than in the PMT group (P-value < 0.001). The scores of 40% of the APT group and 80% of the PMT group did not fall below the cut-off point. In the APT group after the intervention, the inattention subscale was significantly lower than the hyperactivity subscale, while in the PMT group, the hyperactivity subscale was lower. The effect sizes of APT and PMT were 2.18 and 2.09, respectively. Conclusion: For ADHD, psychological interventions are crucial in addition to medication. According to the results of this study, APT is more effective for inattention symptoms, while PMT is more effective for hyperactivity symptoms. When selecting psychotherapy, the subtype of ADHD should be taken into account. Treatment sessions must also be completed according to intervention protocols.
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Affiliation(s)
- Mehriar Nadermohammadi Moghadam
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Parisa Bakhshi
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Anita Azarkollah
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Behnam Moulai
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Parviz Molavi
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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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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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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6
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Leon L, Tran T, Navadia M, Patel J, Vanderveen A, Cruz MI, Le TM, Assuah FB, Prager V, Patel D, Costin JM. Alternative Treatments to Pharmacological Therapy in Pediatric Populations With Attention-Deficit/Hyperactivity Disorder (ADHD): A Scoping Review. Cureus 2024; 16:e55792. [PMID: 38586804 PMCID: PMC10999167 DOI: 10.7759/cureus.55792] [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: 10/29/2023] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
In recent years, there has been an increase in the prevalence of the diagnosis of attention-deficit/hyperactivity disorder (ADHD), a cognitive and behavioral disorder in which individuals present with inattention and impulsivity, in the pediatric population. With an increase in diagnoses, there is also increasing concern regarding overdiagnosis and overtreatment with medications for ADHD. The objective of this study was to map out and compile the recent literature pertaining to alternative therapies (e.g., physical activity, diet, mindfulness, and computer-based interventions) for children and adolescents diagnosed with ADHD in an attempt to reduce or replace the use of pharmacological therapy. This scoping review searched articles from multiple databases (PubMed, ScienceDirect, Web of Science, Directory of Open Access Journals, Scopus, and CINAHL). Using search terms "children with ADHD," "alternative treatment," and "cognitive behavioral therapy," articles were identified that were specific to the research question. The inclusion criteria were patients under the age of 18 with a previous diagnosis of ADHD, no other comorbid illnesses, alternative treatments, and was limited to studies published between 2012 and 2022. After removing duplicates, screening for eligibility criteria, and conducting a critical appraisal of the articles, 16 articles were retained for the final review. The main alternative therapeutic domains that emerged were (1) physical activity, (2) diet, (3) mindfulness, (4) computer-based interventions, and (5) miscellaneous interventions. Seven articles assessed the effect of physical activity on executive and cognitive function in children and adolescents with ADHD. Most findings showed improvement with increased physical activity. Two articles explored the effect of diet on the improvement of ADHD symptoms and reported a positive impact. The two articles that evaluated the effects of mindfulness on ADHD symptoms reported a reduction in ADHD symptoms. Two studies evaluated the use of computer-based interventions as an adjunct treatment in children and adolescents with ADHD; improvements in symptoms were reported. One study each evaluated interventions based on music and nerve stimulation. These showed an improvement in attention, memory, and executive function. With the increasing prevalence of ADHD diagnosis in children and adolescents, alternative and/or adjunctive treatments may be a viable and valuable alternative to pharmaceutical interventions. The findings from this review suggest that multiple non-pharmacological interventions effectively reduce symptoms of ADHD in children and adolescents, including diet, exercise, mindfulness, computer-based interventions, music, and nerve stimulation. While there are implications for alternatives to be used in the future, more research is warranted using larger samples with controlled trials.
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Affiliation(s)
- Lexie Leon
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Tram Tran
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Meera Navadia
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Janavi Patel
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Annelies Vanderveen
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Maria I Cruz
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Thuy-Mai Le
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Freda B Assuah
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Victoria Prager
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Darshil Patel
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Joshua M Costin
- Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
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7
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Ferguson C, Hobson C, Hedge C, Waters C, Anning K, van Goozen S. Disentangling the relationships between motor control and cognitive control in young children with symptoms of ADHD. Child Neuropsychol 2024; 30:289-314. [PMID: 36946244 DOI: 10.1080/09297049.2023.2190965] [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: 12/06/2022] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
Children with ADHD experience difficulties with motor and cognitive control. However, the relationships between these symptoms are poorly understood. As a step toward improving treatment, this study investigated associations between specific aspects of motor control and cognitive control in children with varying levels of hyperactive-impulsive symptoms. A heterogeneous sample of 255 children of 4 to 10 years of age (median = 6.50, MAD = 1.36) completed a battery of tests probing motor generation, visuomotor fluency, visuomotor flexibility, cognitive inhibition, verbal and visuospatial working memory, and cognitive flexibility. Their caregivers were interviewed regarding their hyperactive-impulsive symptoms. 25.9% of the main sample met diagnostic criteria for ADHD. Multiple linear regression analysis was used to determine whether specific aspects of motor control were associated with specific aspects of cognitive control, and whether any associations were moderated by hyperactive-impulsive symptoms. Additionally, cognitive modeling (the drift diffusion model approximated with EZ-DM) was used to understand performance on a cognitive inhibition task. Visuomotor fluency was significantly associated with cognitive inhibition. Visuomotor flexibility was significantly associated with cognitive flexibility. There were no significant moderation effects. Cognitive modeling was inconclusive. In conclusion, the ability to fluently perform visually guided continuous movement is linked with the ability to inhibit the effects of distracting information. The ability to spontaneously use visual information to flexibly alter motor responses is related to the ability to cognitively shift from one frame of mind to another. These relationships appear to be quantitatively and qualitatively similar across the childhood hyperactive-impulsive continuum as rated by parents.
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Affiliation(s)
- Cameron Ferguson
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- Community Neurological Rehabilitation Service, Aneurin Bevan University Health Board, NHS Wales, Newport, United Kingdom
| | - Christopher Hobson
- South Wales Doctoral Programme in Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, United Kingdom
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
| | - Craig Hedge
- School of Psychology, Aston University, Aston, United Kingdom
| | - Cerith Waters
- South Wales Doctoral Programme in Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, United Kingdom
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
| | - Kate Anning
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
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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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9
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Moffat R, Caruana N, Cross ES. Inhibiting responses under the watch of a recently synchronized peer increases self-monitoring: evidence from functional near-infrared spectroscopy. Open Biol 2024; 14:230382. [PMID: 38378138 PMCID: PMC10878812 DOI: 10.1098/rsob.230382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/30/2024] [Indexed: 02/22/2024] Open
Abstract
Developing motor synchrony with a peer (through interventions such as the mirror game) can yield collaborative, cognitive and social benefits. However, it is also well established that observation by an audience can improve cognition. The combined and relative advantages offered by motor synchronization and audience effects are not yet understood. It is important to address this gap to determine the extent to which synchronizing activities might interact with the positive effects of an audience. In this preregistered study, we investigate the extent to which response inhibition may be improved when observed by a peer after motor synchronization with this peer. We compare behavioural and cortical (functional near-infrared spectroscopy; fNIRS) measures of inhibition between synchronized and non-synchronized dyads and find that the presence of a synchronized peer-audience introduces a speed-accuracy trade-off, consisting of slower reaction times and improved accuracy. This co-occurs with cortical activation in bilateral inferior frontal and middle prefrontal cortices, which are implicated in monitoring and maintenance of social alignment. Our findings have implications for carers and support people, who may benefit from synchronizing activities for rehabilitating inhibition and social skills in clinical settings.
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Affiliation(s)
- R. Moffat
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
- Professorship for Social Brain Sciences, ETH Zurich, Zurich 8092, Switzerland
| | - N. Caruana
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia, Australia
| | - E. S. Cross
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead Innovation Quarter Building U, Westmead New South Wales 2145, Australia
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow G12 8QB, UK
- Professorship for Social Brain Sciences, ETH Zurich, Zurich 8092, Switzerland
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10
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Wong KP, Qin J, Xie YJ, Zhang B. Effectiveness of Technology-Based Interventions for School-Age Children With Attention-Deficit/Hyperactivity Disorder: Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR Ment Health 2023; 10:e51459. [PMID: 37988139 DOI: 10.2196/51459] [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: 08/01/2023] [Revised: 10/05/2023] [Accepted: 10/22/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is relatively common among school-age children. Technology-based interventions, such as computer-assisted training programs, neurofeedback training, and virtual reality, show promise in regulating the behaviors and cognitive functions of children with ADHD. An increasing number of randomized controlled trials have been conducted to evaluate the effectiveness of these technologies in improving the conditions of children with ADHD. OBJECTIVE This study aims to conduct a systematic review of technological interventions for school-age children with ADHD and perform a meta-analysis of the outcomes of technology-based interventions. METHODS A total of 19 randomized controlled studies involving 1843 participants were selected from a pool of 2404 articles across 7 electronic databases spanning from their inception to April 2022. ADHD behaviors, cognitive functions, learning ability, and quality of life were addressed in this study. RESULTS Random effects meta-analyses found that children with ADHD receiving technology-based intervention showed small and significant effect sizes in computer-rated inattention (standardized mean difference [SMD] -0.35; P<.04), parent-rated overall executive function measured by the Behavior Rating Inventory of Executive Function (SMD -0.35; P<.04), parent-rated disruptive behavior disorder measured by the Child Behavior Checklist (SMD -0.50; P<.001) and Disruptive Behavior Disorder Rating Scale (SMD -0.31; P<.02), and computer-rated visual attention measured by the Continuous Performance Test (SMD -0.42; P<.001) and Reaction Time (SMD -0.43; P<.02). CONCLUSIONS Technology-based interventions are promising treatments for improving certain ADHD behaviors and cognitive functions among school-age children with ADHD. TRIAL REGISTRATION PROSPERO CRD42023446924; https://tinyurl.com/7ee5t24n.
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Affiliation(s)
- Ka Po Wong
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Jing Qin
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Bohan Zhang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
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11
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Robledo-Castro C, Lerma-Castaño PR, Bonilla-Santos G. Effect of Cognitive Training Programs Based on Computer Systems on Executive Functions in Children With ADHD: A Systematic Review. J Atten Disord 2023; 27:1467-1487. [PMID: 37477014 DOI: 10.1177/10870547231187164] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND The purpose of this systematic review is to synthesize the existing literature reporting the effects of computerized cognitive trainings on the executive functions of children with ADHD. METHOD A systematic review was carried out following the PRISMA statement; the primary sources used were five electronic databases (Scopus, Science Direct, Pubmed, Springer, Taylor & Francis). RESULTS 20 articles met the eligibility criteria, data on the training characteristics and the effects on executive functions were extracted, followed by an analysis of bias and the methodological quality of the studies. The results of the studies were widely heterogeneous, largely associated with the variety of training programs and the measurement instruments used. The most studied executive functions were working memory and inhibitory control. Some of the studies reported that the intervention led to significant effects on working memory and attention (N = 7), and improvements in inhibitory control (N = 5) and planning (N = 4) were also reported. At the same time, others did not report the effects of the intervention on these processes. The assessment of the quality of the evidence showed important risk biases among the reviewed studies. CONCLUSION Some training based on computer systems showed positive effects on the executive functions of working memory, attention, and inhibitory control in children with ADHD. However, other training sessions did not show significant effects. In general, the evidence shows mixed results, a high diversity of measurement instruments, and high risks of bias between the studies. Therefore, the evidence has not been consistent about the general benefits of computerized training on the executive functions of children with ADHD.
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Affiliation(s)
| | - Piedad Rocio Lerma-Castaño
- Universidad Autónoma de Manizales, Caldas, Colombia
- Fundación Universitaria María Cano, Neiva Huila, Colombia
| | - Gisella Bonilla-Santos
- Fundación Universitaria María Cano, Neiva Huila, Colombia
- Universidad Surcolombiana, Neiva, Colombia
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Tallberg P, Rastam M, Hallin AL, Perrin S, Gustafsson P. A longitudinal investigation of parental ratings and performance metrics for executive functioning and symptom severity in clinically referred youth with ADHD. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:259-271. [PMID: 36126650 DOI: 10.1080/21622965.2022.2093113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There remains a knowledge gap concerning the persistence of attention deficit hyperactivity disorder (ADHD) over the longer term. The current study aimed to investigate the change in parent-rated, and performance-based metrics of executive functioning (EF) and the relationship between these EF metrics and ADHD symptoms in individuals with ADHD from childhood/adolescence to young adulthood. This was done by examining possible improvements in parent-rated EF and performance-based measures of inattention and inhibition over a three-year interval and their relationship to ADHD outcomes in 137 clinically referred youth with ADHD (mean age = 12.4 years, SD = 3.1). Participants' parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Swanson-Nolan-Pelham Scale at baseline and follow-up. Participants completed the Conners' Continuous Performance Test, Version II (CPT II) at baseline and follow-up. Statistical analyses were performed with Linear Mixed Models. The sex- and age-standardized measures Commission and Hit reaction time (RT) subscales of the CPT II and parent-rated metacognitive, and behavior regulation composites of the BRIEF were largely stable between measuring points. CPT Omissions, Hit RT standard error (reaction time variability), and parent-rated ADHD symptom scores improved slightly. BRIEF composites and reaction time variability were related to ADHD symptoms using longitudinal data. Overall, behavioral aspects of EF, as observed by parents in the home context, appear to play a significant role in the trajectory of childhood ADHD.
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Affiliation(s)
- Pia Tallberg
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Maria Rastam
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Psychiatry and Neurochemistry, Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Anne-Li Hallin
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | - Peik Gustafsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
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13
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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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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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McKay E, Kirk H, Coxon J, Courtney D, Bellgrove M, Arnatkeviciute A, Cornish K. Training inhibitory control in adolescents with elevated attention deficit hyperactivity disorder traits: a randomised controlled trial of the Alfi Virtual Reality programme. BMJ Open 2022; 12:e061626. [PMID: 36127121 PMCID: PMC9490587 DOI: 10.1136/bmjopen-2022-061626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is characterised by significant deficits in attention and inhibition. These deficits are associated with negative sequelae that emerge in childhood and often continue throughout adolescence. Despite these difficulties adolescents with ADHD often demonstrate poor treatment compliance with traditional interventions (eg, psychostimulant medication). Virtual reality (VR) presents an innovative means of delivering engaging cognitive interventions for adolescents with ADHD and offers the potential to improve compliance with such interventions. The current parallel, randomised controlled trial aims to evaluate the effects of a VR intervention (Alfi) designed to improve inhibition in adolescents with ADHD. METHODS AND ANALYSIS A sample of 100 adolescents (aged 13-17) with elevated ADHD symptoms will be recruited from secondary schools and ADHD organisations located in the state of Victoria, Australia. Participants will be randomly assigned to either an 8-week VR intervention or a usual care control. The VR intervention involves the completion of 14 sessions, each 20 min in duration. Participants will complete computerised assessments of inhibition and risk-taking preintervention and immediately postintervention. Parents/guardians will complete online questionnaires about their child's ADHD symptoms and social functioning at each of these timepoints. The primary outcome is change in inhibition performance in adolescents who received the intervention from preintervention to postintervention compared with adolescents in the control condition. Secondary outcomes include change in risk-taking, ADHD symptoms and social functioning in adolescents who received the intervention from preintervention to postintervention compared with adolescents in the control condition. If the intervention is shown to be effective, it may offer a supplementary approach to traditional interventions for adolescents with ADHD experiencing inhibitory control difficulties. ETHICS AND DISSEMINATION This trial has ethics approval from the Monash University Human Research Ethics Committee (HREC) (21530) and the Victorian Department of Education and Training HREC (2020_004271). Results will be disseminated through peer-reviewed journals, conference proceedings and community activities. Individual summaries of the results will be provided to participants on request. TRIAL REGISTRATION NUMBER ACTRN12620000647932.
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Affiliation(s)
- Erin McKay
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Hannah Kirk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - James Coxon
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Danielle Courtney
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Mark Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Aurina Arnatkeviciute
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Kim Cornish
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Arpaia P, Covino A, Cristaldi L, Frosolone M, Gargiulo L, Mancino F, Mantile F, Moccaldi N. A Systematic Review on Feature Extraction in Electroencephalography-Based Diagnostics and Therapy in Attention Deficit Hyperactivity Disorder. SENSORS 2022; 22:s22134934. [PMID: 35808424 PMCID: PMC9269717 DOI: 10.3390/s22134934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023]
Abstract
A systematic review on electroencephalographic (EEG)-based feature extraction strategies to diagnosis and therapy of attention deficit hyperactivity disorder (ADHD) in children is presented. The analysis is realized at an executive function level to improve the research of neurocorrelates of heterogeneous disorders such as ADHD. The Quality Assessment Tool for Quantitative Studies (QATQS) and field-weighted citation impact metric (Scopus) were used to assess the methodological rigor of the studies and their impact on the scientific community, respectively. One hundred and one articles, concerning the diagnostics and therapy of ADHD children aged from 8 to 14, were collected. Event-related potential components were mainly exploited for executive functions related to the cluster inhibition, whereas band power spectral density is the most considered EEG feature for executive functions related to the cluster working memory. This review identifies the most used (also by rigorous and relevant articles) EEG signal processing strategies for executive function assessment in ADHD.
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Affiliation(s)
- Pasquale Arpaia
- Department of Electrical Engineering and Information Technologies (DIETI), University of Naples “Federico II”, 80121 Naples, Italy; (M.F.); (L.G.); (F.M.); (N.M.)
- Interdepartmental Research Center on Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80121 Naples, Italy
- Correspondence:
| | - Attilio Covino
- Villa delle Ginestre, Rehabilitation Center, 80040 Naples, Italy; (A.C.); (F.M.)
| | - Loredana Cristaldi
- Department of Electronics, Information e Bioengineering, Milan Polytechnic, 20133 Milan, Italy;
| | - Mirco Frosolone
- Department of Electrical Engineering and Information Technologies (DIETI), University of Naples “Federico II”, 80121 Naples, Italy; (M.F.); (L.G.); (F.M.); (N.M.)
| | - Ludovica Gargiulo
- Department of Electrical Engineering and Information Technologies (DIETI), University of Naples “Federico II”, 80121 Naples, Italy; (M.F.); (L.G.); (F.M.); (N.M.)
| | - Francesca Mancino
- Department of Electrical Engineering and Information Technologies (DIETI), University of Naples “Federico II”, 80121 Naples, Italy; (M.F.); (L.G.); (F.M.); (N.M.)
| | - Federico Mantile
- Villa delle Ginestre, Rehabilitation Center, 80040 Naples, Italy; (A.C.); (F.M.)
| | - Nicola Moccaldi
- Department of Electrical Engineering and Information Technologies (DIETI), University of Naples “Federico II”, 80121 Naples, Italy; (M.F.); (L.G.); (F.M.); (N.M.)
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Trapp W, Heid A, Röder S, Wimmer F, Hajak G. Cognitive Remediation in Psychiatric Disorders: State of the Evidence, Future Perspectives, and Some Bold Ideas. Brain Sci 2022; 12:683. [PMID: 35741569 PMCID: PMC9221116 DOI: 10.3390/brainsci12060683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 12/10/2022] Open
Abstract
Many people with psychiatric disorders experience impairments in cognition. These deficits have a significant impact on daily functioning and sometimes even on the further course of their disease. Cognitive remediation (CR) is used as an umbrella term for behavioral training interventions to ameliorate these deficits. In most but not all studies, CR has proven effective in improving cognition and enhancing everyday functional outcomes. In this paper, after quickly summarizing the empirical evidence, practical advice to optimize the effects of CR interventions is provided. We advocate that CR interventions should be as fun and motivating as possible, and therapists should at least consider using positively toned emotional stimuli instead of neutral stimuli. Participants should be screened for basic processing deficits, which should be trained before CR of higher-order cognitive domains. CR should stimulate metacognition and utilize natural settings to invoke social cognition. Wherever possible, CR tasks should link to tasks that participants face in their everyday life. Therapists should consider that participants might also benefit from positive side effects on symptomatology. Finally, the CR approach might even be utilized in settings where the treatment of cognitive impairments is not a primary target.
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Affiliation(s)
- Wolfgang Trapp
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany
- Fachhochschule des Mittelstands, Department of Psychology, University of Applied Sciences, 96050 Bamberg, Germany
| | - Andreas Heid
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany
| | - Susanne Röder
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany
| | - Franziska Wimmer
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany
| | - Göran Hajak
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany
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Nejati V, Majidinezhad M, Nitsche M. The role of the dorsolateral and ventromedial prefrontal cortex in emotion regulation in females with major depressive disorder (MDD): A tDCS study. J Psychiatr Res 2022; 148:149-158. [PMID: 35124394 DOI: 10.1016/j.jpsychires.2022.01.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/29/2021] [Accepted: 01/13/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Individuals with major depressive disorder (MDD) have deficits in emotion regulation, which plays a putative role in psychopathology. The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are assumed to be involved in respective processes. In the present study, we aimed to explore the effect of stimulation over the dlPFC and vmPFC on emotion regulation in female with MDD. MATERIAL AND METHODS Twenty women with MDD performed the Emotional Stroop, Emotional Go/No-Go, and Emotional 1-Back tasks during transcranial direct current stimulation (tDCS) in three separate sessions with the following electrode montages: anodal dlPFC (F3)/cathodal vmPFC (Fp2), anodal vmPFC (Fp2)/cathodal dlPFC (F3), and sham stimulation. RESULTS Independent of the valence of the respective stimuli, accuracy and speed of interference control, accuracy of pre-potent inhibition, and accuracy, but not speed, of working memory performance improved during anodal left dlPFC/cathodal right vmPFC stimulation. Independent of stimulation conditions, interference control was reduced for sad faces, as compared to happy and neutral faces, and working memory performance was faster for happy than for neutral and sad faces. For the impact of stimulation on specific emotional qualities, anodal left dlPFC/cathodal right vmPFC, compared to sham stimulation, led to improved interference control of sad and neutral faces in the emotional Stroop task, as shown by faster reaction times. Furthermore, in that task accuracy with respect to neutral and happy face conditions was higher during both real stimulation conditions, as compared to sham stimulation. CONCLUSION The dlPFC is involved in emotion regulation in MDD. Emotional valence is moreover relevant for the effect of stimulation over this area on interference control in MDD.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University Tehran, Tehran, Po box: 1983969411, Iran.
| | - Maryam Majidinezhad
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health(Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Michael Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Department of Psychology and Neurosciences, Dortmund, Germany; University Medical Hospital Bergmannsheil, Department of Neurology, Bochum, Germany
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Lanoye A, Adams E, Fuemmeler BF. Obesity and Attention-Deficit Hyperactivity Disorder. Curr Top Behav Neurosci 2022; 57:221-241. [PMID: 35505058 DOI: 10.1007/7854_2022_337] [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: 06/14/2023]
Abstract
An association between ADHD and obesity has been established throughout the past 20 years via animal model experiments and both correlational and longitudinal studies in humans. However, much remains to be determined regarding causality, developmental course, and effective treatments targeting both conditions. This chapter provides an overview and update on the current state of the science on the relationship between obesity and ADHD; expands the scope of the connection between obesity and ADHD to include behavioral components important to weight regulation - i.e., physical activity, eating behaviors, and sleep; and presents applications of these findings to treatment approaches and future directions.
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Affiliation(s)
- Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth Adams
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
- Research Center for Child Well-Being, University of South Carolina, Columbia, SC, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
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Bonete S, Osuna Á, Molinero C, García-Font I. MAGNITIVE: Effectiveness and Feasibility of a Cognitive Training Program Through Magic Tricks for Children With Attention Deficit and Hyperactivity Disorder. A Second Clinical Trial in Community Settings. Front Psychol 2021; 12:649527. [PMID: 33868126 PMCID: PMC8049719 DOI: 10.3389/fpsyg.2021.649527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/05/2021] [Indexed: 11/28/2022] Open
Abstract
Previous studies have explored the impact of magic tricks on different basic cognitive processes yet there is a need of examining effectiveness of a cognitive training program through magic tricks for children with attention deficit hyperactivity disorder (ADHD). The present study examines the effectiveness and feasibility of the MAGNITIVE program, a manualized intervention for cognitive training through the learning of magic tricks. A total of 11 children with ADHD (from 8 to 12 years) participated in separated groups of two different community settings (hospital center and school), and were assessed at pre-treatment, post-treatment, and a 3-month later follow-up in different tasks involving processing speed, sustained attention, selective attention, and mental flexibility. Using non parametric statistical analyses and Reliable Change Index, the results showed that these children receiving MAGNITIVE particularly improved their performance in sustained attention, shifting attention, and mental flexibility, changes were also observed in processing speed performance yet further research is needed in terms of selective attention and inhibition, given the great individual differences within this sample. Changes were maintained when the program was finished. In terms of viability, the study proved a good treatment integrity in different contexts (hospital and school setting), adherence to the curriculum (attendance and some practice at home), and high levels of engagement satisfaction. In this second clinical trial, MAGNITIVE program appears to be a feasible training program for children with ADHD, as an alternative for medication when possible.
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Affiliation(s)
- Saray Bonete
- Department of Psychology, Universidad Francisco de Vitoria, Madrid, Spain
| | - Ángela Osuna
- Department of Psychology, Universidad Francisco de Vitoria, Madrid, Spain
| | - Clara Molinero
- Department of Psychology, Universidad Francisco de Vitoria, Madrid, Spain
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Shanok NA, Meltzer K, Frank C, Lugo V, Jones NA. Computerized inhibitory control training reduces anxiety in preadolescent students. APPLIED NEUROPSYCHOLOGY-CHILD 2021; 11:455-470. [PMID: 33605177 DOI: 10.1080/21622965.2021.1884984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The study examined the relationship between anxiety, inhibitory control (IC), and resting-state electroencephalography (EEG) in a critical age-range for social and emotional development (8-12-year-olds). The participants were assigned to 4 weeks of either an emotional IC training program, a neutral IC training program, or a waitlisted control, and were tested using cognitive, emotional, and EEG measures. The training was computerized and completed remotely. At baseline, IC accuracy scores were negatively related to both anxiety and depression levels (N = 42). Additionally, increased right lateral frontal alpha asymmetry was predictive of increased anxiety/depression scores. A series of multivariate analyses of covariance and post-hoc tests were conducted to compare effects in the participants that completed the full 16 sessions of training (N = 32). Overall the emotional and neutral training conditions showed similar improvements in IC accuracy, as well as reductions in anxiety compared to the waitlist condition. Minimal neurophysiological changes occurred from pre-to-post; however, lateral frontal asymmetry shifted leftward in the emotional training group. These findings highlight the potential of computerized IC training for mitigating negative emotional functioning in preadolescents. Future research is necessary to determine the long-term effects of IC training and whether longer training intervals facilitate persisting impacts.
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Affiliation(s)
- Nathaniel A Shanok
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Kelsey Meltzer
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Colin Frank
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Victoria Lugo
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Nancy Aaron Jones
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
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