Abstract
BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by symptoms of inattention and impulsivity and/or hyperactivity and a range of cognitive dysfunctions. Pharmacological treatment may be beneficial; however, many affected individuals continue to have difficulties with cognitive functions despite medical treatment, and up to 30 % do not respond to pharmacological treatment. Inadequate medical compliance and the long-term effects of treatment make it necessary to explore nonpharmacological and supplementary treatments for ADHD. Treatment of cognitive dysfunctions may prove particularly important because of the impact of these dysfunctions on the ability to cope with everyday life. Lately, several trials have shown promising results for cognitive computer training, often referred to as cognitive training, which focuses on particular parts of cognition, mostly on the working memory or attention but with poor generalization of training on other cognitive functions and functional outcome. Children with ADHD have a variety of cognitive dysfunctions, and it is important that cognitive training target multiple cognitive functions.Methods/DesignThis multicenter randomized clinical superiority trial aims to investigate the effect of “ACTIVATE™,” a computer program designed to improve a range of cognitive skills and ADHD symptoms. A total of 122 children with ADHD, aged 6 to 13 years, will be randomized to an intervention or a control group. The intervention group will be asked to use ACTIVATE™ at home 40 minutes per day, 6 days per week for 8 weeks. Both intervention and control group will receive treatment as usual. Outcome measures will assess cognitive functions, symptoms, and behavioral and functional measures before and after the 8 weeks of training and in a 12- and 24-week follow-up.DiscussionResults of this trial will provide useful information on the effectiveness of computer training focusing on several cognitive functions. Cognitive training has the potential to reduce cognitive dysfunctions and to become a new treatment option, which can promote a more normal neural development in young children with ADHD and thus reduce cognitive dysfunctions and symptoms. This could help children with ADHD to perform better in everyday life and school.Trial registrationClinicalTrials.gov: NCT01752530, date of registration: 10 December 2012
Highlights
Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by symptoms of inattention and impulsivity and/or hyperactivity and a range of cognitive dysfunctions
Results of this trial will provide useful information on the effectiveness of computer training focusing on several cognitive functions
Discussion of clinical relevance If the trial results indicate that this intervention reduces specific cognitive deficits in children with ADHD
Summary
Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by symptoms of inattention and impulsivity and/or hyperactivity and a range of cognitive dysfunctions. Impulse inhibition and vigilance are found to be the most impaired functions according to two large meta-analyses of observational studies comparing cognitive functions in patients with ADHD with healthy participants [18, 19]. Selective and sustained attention, attention switching and processing speed are significantly impaired [16, 20,21,22] These features are associated with the executive control system [23,24,25,26] and are often manifest in early childhood and persistent over time [11, 27]. Children with ADHD display significant impairment in executive functions compared to typically developing controls as a group, but only 50 % of the patients exhibit executive dysfunctions at the individual level [28]
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