Executive Function Deficits Research Articles

Cognitive profile of kidney transplant patients and impact of deceased vs. living donor transplantation

BackgroundIt is important to learn more about the prevalence, severity and characteristics (i.e., which cognitive abilities are especially affected) of cognitive impairment in kidney transplant patients. Furthermore, the impact of living vs. deceased donor renal transplantation on cognitive outcome in this patient group needs further studies.MethodsFifty-nine patients (43 men, age 55 ± 13 years) who received a deceased donor or living donor kidney transplant, completed a comprehensive neuropsychological test assessment. Neuropsychological tests explored the cognitive domains of verbal and visual memory, attention, and executive functions.ResultsFifteen percent of the patients had mild, 25% moderate, and 15% severe cognitive impairment. The level of domain-specific cognitive deficit differed between verbal memory, attention, and executive functions (χ2(2) = 7.11, p = 0.029). On average, patients showed the highest deficit in executive functions, and the lowest deficit in verbal memory. Patients who received a kidney graft from a deceased donor were more likely to have a cognitive impairment than those who received a kidney graft from a living donor (OR = 3.03, 95% CI [0.99,9.32], Wald χ2(1) = 3.74, p = 0.053). This effect was independent of time on dialysis as well as of creatinine levels, or creatinine clearance.ConclusionsOur results show that in kidney transplant patients with cognitive impairment, the cognitive domain of executive functions is the most affected one. This might be detrimental for quality of life. The fact that patients who received living donor kidneys seem to do better in terms of cognition than patients with deceased donor kidneys deserves more attention in future research.Graphical abstract

The role of emotional regulation, executive functioning, and aggression in hoarding behaviours

Emotion regulation (ER), executive function (EF) and aggression have all been separately linked with hoarding behaviours. This study aimed to investigate whether difficulties with ER, deficits in EF, and an increase in aggression are linked with hoarding behaviours in a community sample, whilst controlling for anxiety, depression, age, and sex. Using a correlational design, we recruited 225 adults who completed questionnaires of anxiety and depression, hoarding severity, difficulties with ER, EF, and aggression. Two hierarchical multiple regressions were conducted to uncover which factors predicted an increase in hoarding behaviours, as well as the unique variance of these contributing factors. They revealed that difficulties with ER and physical aggression both contributed unique variance to hoarding severity scores. Further research is needed to fully uncover the relationship between aggression and HD, and the interconnection between EF and ER. The current study, although not without its limitations, has implications for further research in clinical samples.

Unusual Predominant Memory Decline in an Early-Stage CADASIL Patient: A Four-Year Longitudinal Follow-Up of Hereditary Vascular Dementia

Introduction: Deficits in executive function and processing speed have traditionally been viewed as the chief cognitive manifestation of vascular contributions to cognitive impairment and dementia. This case study describes the longitudinal progression of cognitive symptoms in a 42-year-old Colombian woman with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a hereditary condition leading to the early onset of cerebral small vessel disease. Because of the young age of onset of vascular cognitive impairment, CADASIL allows examining the early cognitive consequences of cerebrovascular changes in the absence of age-related comorbidities. Methods: We followed the neuropsychological progression of a non-demented and stroke-free patient carrying a CADASIL mutation, in parallel to that of 13 non-carrier control subjects. At baseline, all subjects completed detailed clinical, neurological, and neuropsychological evaluations as well as an MRI scan. After a period of four years, subjects completed a follow-up neuropsychological evaluation. Results: Examination of the patient’s baseline MRI revealed the presence of significant areas of white matter hyperintensity. The patient did not present cerebral microbleeds, lacunes, notable brain atrophy, or evidence of previous strokes. In contrast to non-carrier subjects, the patient experienced predominant memory decline, with relatively preserved executive function and processing speed. Conclusions: This case highlights the heterogeneity of cognitive deficits associated with cerebrovascular disease.

Hot Executive Function in Autism Spectrum Disorder: A Brief Narrative Review

Executive function (EF), encompassing high-order cognitive processes essential for goal-directed behavior, is often impaired in Autism Spectrum Disorder (ASD). This review addresses the problem of limited understanding regarding the distinction between “cool” and “hot” EF, their respective manifestations, and developmental trajectories in ASD. While cool EF in ASD has been widely investigated, the impairments and development of hot EF are less explored despite potentially also playing a role in ASD's socio-cognitive challenges. The purpose of this narrative review is to synthesize existing literature on hot EF and its development in ASD, particularly in relation to cool EF. Our approach involves a comprehensive examination of current studies to identify gaps and propose directions for future research. The review highlights the scarcity of studies on hot EF in ASD and concludes that targeted interventions should address both cool and hot EF deficits. Future research directions include longitudinal studies, neural investigations, and culturally diverse samples to further elucidate the role of hot EF in ASD. Understanding these distinctions can refine intervention strategies, ultimately enhancing support for individuals with ASD.

Long-term cognitive outcomes in Susac syndrome: A case series

Susac syndrome (SuS) presents with encephalopathy, visual disturbances, and hearing loss from immune-mediated microvascular occlusion. While acute SuS is well-described, long-term cognitive outcomes with current treatments are underknown. We assessed ten SuS patients treated in accordance with evidence-based guidelines using immunotherapies targeting humoral and cell-mediated pathways. Patients were followed for a median 3.6 years. Initially, cognition inversely correlated with corpus callosum lesions on MRI. All reported cognitive improvement; 5/10 patients had residual deficits in visual attention and executive function. Early, aggressive treatment was associated with good outcomes; extensive early corpus callosum lesions may identify patients at-risk of persistent cognitive deficits.

CNSC-01. UNDERSTANDING PEDIATRIC BRAIN TUMOR CHEMOTHERAPY INDUCED LONG-TERM DEFICITS IN HIGH-ORDER NEUROCOGNITIVE AND SENSORIMOTOR FUNCTION

Abstract BACKGROUND Because of major advancements in cancer treatment especially chemotherapy, 85% of children with cancer are predicted to survive for 5 years or more. However, chemotherapy can cause long-term health problems when childhood cancer survivors enter adulthood (known as late effects). The neurocognitive features of these late effects (chemobrain) include trouble in concentrating, memorizing, and decreased processing speed, and results in lower IQ and academic achievement, poor hand-eye coordination, and slower development over time. Despite such a negative impact on the quality of life of cancer-surviving children, the mechanism is poorly understood and there is no FDA-approved drug to prevent or cure these side effects. METHODS To gain a better understanding of the mechanism underlying chemotherapy-induced cognitive impairments, we developed a pre-clinical model using carboplatin in juvenile mice to study long-term neurological defects. We have tested the capacity of different doses of carboplatin and its long-term effect on cognitive and sensorimotor function and performed single nuclear RNA sequencing (snRNAseq) of the hippocampus. RESULTS Our preliminary data demonstrated dose-dependent deficits in executive and sensorimotor function 7-9 weeks after carboplatin administration in the mice of both sexes. snRNAseq of the hippocampus showed changes in the glial cell number as well as genes associated with oxidative phosphorylation and neurodegeneration at early and late time points. CONCLUSIONS This study established a preclinical model that can be leveraged to mechanistically understand the long-term neurocognitive side effects of brain tumor chemotherapy during childhood. Future studies will aim to identify potential targets to prevent and/or treat the neurotoxic effects of cancer treatment in pediatric patients.

Postoperative Cognitive Decline in Patients Undergoing Major Gynecologic Oncology Surgery: A Pilot Prospective Study

ObjectivesPostoperative cognitive decline (POCD) is characterised by deficits in attention, memory, executive function, and information processing that persist beyond the early postoperative period. Its incidence ranges from 10%–25% after noncardiac surgery. Limited literature exists on POCD after gynecologic oncology surgery. Our primary objective was to identify the incidence of POCD among patients 55 years or older undergoing major gynecologic oncology surgery. MethodsThis mixed-methods, prospective, observational cohort study followed patients 55 years or older who underwent surgery for gynecologic malignancies between February and July 2022. Semi-structured interviews and the Mini-Mental State Exam (MMSE) were administered before surgery as well as 1 and 3 months after. Assessments were delivered virtually and in-person in the context of the COVID-19 pandemic. POCD was defined as ≥2-point decline from baseline MMSE score. ResultsTwenty-four patients participated; 19 completed the 1-month follow-up, and 15 completed the 3-month follow-up. The average age was 64 (range: 56–90). The mean preoperative MMSE score was 16.6 out of 17 (virtual) and 12.9 out of 13 (in-person). Two patients had a 1-point decline in their 1-month MMSE score; both recovered by 3 months. One patient had a 1-point decline in their 3-month MMSE score. Semi-structured interviews revealed common themes of “brain fog” at the 1-month follow-up and mild, persistent attention and word-finding deficits at 3 months postoperatively. ConclusionsThis study’s qualitative component captured subtle subjective findings suggestive of potential POCD. Larger studies are required, and a more extensive neuropsychological test battery may be required to elicit subtle findings not clearly reflected by MMSE scores.

Assessing Executive Functioning in Schizophrenia: Concurrent and Discriminative Validity of a Novel Virtual Cooking Task.

Deficits in executive functions (EF) are strongly related to real-life functioning and negative symptoms (NS) in schizophrenia. Recently, virtual reality has enabled more ecologically valid approaches to assess EF in simulated "real-life" scenarios among which the virtual cooking task (VCT) has gained attention. However, the clinical implications of the VCT in schizophrenia have not been investigated exhaustively. In this study, clinically stable individuals with schizophrenia (n = 38) and healthy controls (n = 42) completed a novel VCT and a set of computerized standard EF tools (CST) to primarily investigate concurrent and discriminant validity. In addition, the study explored links between EF assessments, functioning, and NS while controlling for antipsychotic intake, clinical stability, and age. This VCT consisted of four tasks with increasing difficulty and time constraints. The most relevant findings indicate that (1) the VCT showed moderate to strong correlations with CST, (2) the VCT discriminated EF performance between both the groups, (3) the VCT predicted interpersonal functioning, and (4) the VCT predicted NS in greater extent than CST. Accordingly, the findings give support to the concurrent and discriminant validity of the VCT to assess EF and indicate its value to deepen the study of collateral functional deficits and NS in schizophrenia.

The impact of reward and punishment sensitivity on memory and executive performance in individuals with amnestic mild cognitive impairment

Amnestic mild cognitive impairment (aMCI) is defined by memory impairment but executive function (EF) deficits could be also a common feature. This study examined the underlying neurocognitive processes associated with executive function (EF) deficits in patients with aMCI using the Wisconsin Card Sorting Test (WCST) and computational modeling. Forty-two patients with aMCI and thirty-eight matched Controls performed the WSCT and underwent neurocognitive assessment. The Attentional Learning Model was applied the WCST. Patients with aMCI demonstrated deficits in feedback-learning. More specifically, patients showed increased Reward-Sensitivity and reduced Punishment-Sensitivity. These alterations were associated with poor WSCT performance and deficits in EF and Memory. Goal-directed deficits in aMCI, as observed in the WCST, are associated with difficulties in updating attention after feedback as its changes too rapidly following positive feedback and too slowly following negative feedback. Consequently, memory and EF deficits interact and reinforce each other generating performance deficits in patients with aMCI.

Systemic and targeted activation of Nrf2 reverses doxorubicin-induced cognitive impairments and sensorimotor deficits in mice.

While cancer survivorship has increased due to advances in treatments, chemotherapy often carries long-lived neurotoxic side effects which reduce quality of life. Commonly affected domains include memory, executive function, attention, processing speed and sensorimotor function, colloquially known as chemotherapy-induced cognitive impairment (CICI) or "chemobrain". Oxidative stress and neuroimmune signaling in the brain have been mechanistically linked to the deleterious effects of chemotherapy on cognition and sensorimotor function. With this in mind, we tested if activation of the master regulator of antioxidant response nuclear factor E2-related factor 2 (Nrf2) alleviates cognitive and sensorimotor impairments induced by doxorubicin. The FDA-approved systemic Nrf2 activator, diroximel fumarate (DRF) was used, along with our recently developed prodrug 1c which has the advantage of specifically releasing monomethyl fumarate at sites of oxidative stress. DRF and 1c both reversed doxorubicin-induced deficits in executive function, spatial and working memory, as well as decrements in fine motor coordination and grip strength, across both male and female mice. Both treatments reversed doxorubicin-induced loss of synaptic proteins and microglia phenotypic transition in the hippocampus. Doxorubicin-induced myelin damage in the corpus callosum was reversed by both Nrf2 activators. These results demonstrate the therapeutic potential of Nrf2 activators to reverse doxorubicin-induced cognitive impairments, motor incoordination, and associated structural and phenotypic changes in the brain. The localized release of monomethyl fumarate by 1c has the potential to diminish unwanted effects of fumarates while retaining efficacy.

Repeated cognitive assessments show stable function over time in patients with ALS

BackgroundAmyotrophic lateral sclerosis (ALS) is a multisystem disorder with not only motor symptoms but also extra-motor features including cognitive impairment. The most common cognitive profile observed in patients with ALS includes deficits in executive function, language, and social cognition. However, longitudinal studies on cognitive changes over time in ALS are sparse. We aimed to investigate the presence and nature of cognitive impairment at the time of ALS diagnosis and its association with survival as well as explore longitudinal cognitive change.MethodPatients (n = 216) were recruited at the Karolinska University Hospital in Stockholm, Sweden. Follow-up visits (n = 307 in total) were performed every 6 months. Cognitive impairment was assessed using the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) and/or Montreal Cognitive Assessment (MoCA).ResultsCognitive impairment was observed in 38% of the patients at the time of ALS diagnosis, and the majority of these patients had deficits in executive function and/or language. Patients with cognitive impairment at the time of diagnosis had a more rapid decline in ALSFRS-R at 12- and 18-months follow-up, and a shorter survival. Cognitive function was stable during the first 2 years after diagnosis, and did not follow the trajectories of decline in motor functions.ConclusionCognitive impairment in ALS was associated with a faster decline of motor functions, and shorter survival. However, cognitive function did not deteriorate over time. Cognitive assessment is essential for the patients and caregivers to understand the phenotypic expression of ALS.

Mapping the interplay of atrial fibrillation, brain structure, and cognitive dysfunction.

Atrial fibrillation (AF) is associated with an elevated risk of cognitive impairment and dementia. Understanding the cognitive sequelae and brain structural changes associated with AF is vital for addressing ensuing health care needs. We examined 1335 stroke-free individuals with AF and 2683 matched controls using neuropsychological assessments and multimodal neuroimaging. The analysis revealed that individuals with AF exhibited deficits in executive function, processing speed, and reasoning, accompanied by reduced cortical thickness, elevated extracellular free-water content, and widespread white matter abnormalities, indicative of small vessel pathology. Notably, brain structural differences statistically mediated the relationship between AF and cognitive performance. Integrating a comprehensive analysis approach with extensive clinical and magnetic resonance imaging data, our study highlights small vessel pathology as a possible unifying link among AF, cognitive decline, and abnormal brain structure. These insights can inform diagnostic approaches and motivate the ongoing implementation of effective therapeutic strategies. Highlights We investigated neuropsychological and multimodal neuroimaging data of 1335 individuals with atrial fibrillation (AF) and 2683 matched controls. Our analysis revealed AF-associated deficits in cognitive domains of attention, executive function, processing speed, and reasoning. Cognitive deficits in the AF group were accompanied by structural brain alterations including reduced cortical thickness and gray matter volume, alongside increased extracellular free-water content as well as widespread differences of white matter integrity. Structural brain changes statistically mediated the link between AF and cognitive performance, emphasizing the potential of structural imaging markers as a diagnostic tool in AF-related cognitive decline.

Disentangling the relationship between social cognition, executive functions and behaviour changes in amyotrophic lateral sclerosis

BackgroundSocial cognition (SC) deficits are included in the amyotrophic lateral sclerosis-frontotemporal spectrum disorder (ALS-FTDS) revised diagnostic criteria. However, the impact of SC assessment on cognitive classification and the cognitive–behavioural correlates...

INHIBITORY CONTROL IN CHILDREN WITH ATTENTİON DEFİCİT AND HYPERACTİVİTY DİSORDER

The article talks about inhibitory control, which is one of the executive functions in children with ADHD. These children always have impaired executive functions. However, executive dysfunction does not always mean ADHD. Evaluation of executive functions can help diagnose this neurodevelopmental disorder. One of the most common executive function deficits associated with ADHD is problems with inhibitory control. They find it difficult to control inappropriate or impulsive behavior, external interference, and therefore have trouble concentrating. Inhibition plays an important role in successful behavior, requiring the suppression of extraneous interference to focus attention, the ignoring of irrelevant cues to recall stored information, and the suppression of habitual responses to adaptive decision making. Impaired response inhibition directly affects four executive functions: working memory, self-regulation, language internalization, and restructuring. This, in turn, leads to difficulties with complex movements and goal-directed behavior, especially those related to motor control, verbal fluency, and syntax. Given the influence of inhibitory control on ADHD, the author argues that training that enhances inhibition may improve ADHD symptoms. A number of studies in this area have demonstrated the effectiveness of trainings designed to enhance inhibitory control.

Pragmatic Language in Children with Down Syndrom: A Systematic Review

Abstract Background: Down syndrome (SD) is the most common genetic disorder and the easiest to identify. SD or better known as the genetic disorder trisomy, where there is an extra chromosome on chromosome 21. Objectives: Analyzing pragmatic abilities in Down Syndrome children and learning materials in writing scientific research as well as providing additional information regarding pragmatic abilities in Down Syndrome children. Methods: The research carried out is a systematic review research. This research uses data from previous research. A quantitative systematic review combines findings from various independent studies, and produces a statistical summary of those findings (Last, 2001 in Murti, 2018). Results: Down syndrome children show conditions of intellectual problems that are continuous with language problems. Where cognitive abilities are the main capital in communication. Conclusion: Semantic-pragmatic communication abilities create core impairments in the narratives of children with Down syndrome. Pragmatic difficulties and deficits in global executive function when compared with children with other typical development.. Keywords: Pragmatic Language, Dwon syndrome, Systematic review

Distinct attentional and executive profiles in neurofibromatosis type 1: Is there difference with primary attention deficit-hyperactivity disorder?

PurposeAttentional and executive dysfunctions are the most frequent cognitive disorders in neurofibromatosis type 1 (NF1), with a high prevalence of attention deficit-hyperactivity disorder (ADHD). We (i) compared attentional profiles between NF1 children with and without ADHD and children with primary ADHD criteria and (ii) investigated the possible relationship between attentional disorders and “unidentified bright objects” (UBOs) in NF1. MethodsThis retrospective study included 47 NF1 children, 25 with ADHD criteria (NF1+adhd group), matched for age, sex, and cognitive level with 47 children with primary ADHD (ADHD group). We collected computer task (sustained-attention, visuomotor-decision, inhibition, and cognitive-flexibility tasks) scores normalized for age and sex, and brain magnetic resonance imaging data. Results(i) Working memory was impaired in all groups. (ii) Omissions (p < 0.002) and response-time variability (p < 0.05) in sustained-attention and visuomotor-decision tasks and errors (p < 0.02) in the cognitive-flexibility task were lower for the NFI+adhd and ADHD groups than for the NF1-no-adhd group. (iii) The NF1+adhd group had slower response times (p ≤ 0.02) for inhibition and visuomotor-decision tasks than the other groups. (iv) We found no relevant association between cognitive performance and UBOs. ConclusionsNF1 children with ADHD have an attentional and executive functions deficit profile similar to that of children with primary ADHD, but with a slower response-time, increasing learning difficulties. The atypical connectivity of fronto-striatal pathways, poorer dopamine homeostasis, and increased GABA inhibition observed in NF1 renders vulnerable the development of the widely distributed neural networks that support attentional, working-memory, and executive functions.

Cognitive impairment in long-COVID.

<p>Long Covid is a complex con&shy;dition characterised by symptoms that per&shy;sist for weeks and months after the Co&shy;vid infection, accompanied by cognitive im&shy;pairment that negatively affects daily life. Understanding this complex condition is im&shy;portant for the development of diagnostic and therapeutic strategies.</p> <p>This article aims to provide a comprehensive overview of cognitive impairment in long-COVID, including its definition, symptoms, pathophysiology, risk factors, assessment tools, imaging abnormalities, potential biomarkers, management strategies, long-term outcomes, and future directions for research.<br><br><br><br><br></p>. <p>The search methodology used in this review aimed to include a wide range of research on cognitive impairment related to both COVID-19 and long-COVID. Systematic searches of PubMed and Google Scholar databases were conducted using a mixture of MeSH terms and keywords including &lsquo;cognition&rsquo;, &lsquo;cognitive impairment&rsquo;, &lsquo;brain fog&rsquo;, &lsquo;COVID-19&rsquo; and &lsquo;long-COVID&rsquo;. The search was restricted to studies published in English between 1 January 2019 and 11 February 2024, which presented findings on neurological manifestations in human participants.</p>. <p>Long-COVID is characterized by persistent symptoms following COVID-19 infection, with cognitive impairment being a prominent feature. Symptoms include brain fog, difficulties with concentration, memory issues, and executive function deficits. Pa&shy;tho&shy;physiological mechanisms involve vi&shy;ral persistence, immune responses, and vas&shy;cular damage. Risk factors include age, pre-existing conditions, and disease seve&shy;rity. Cognitive assessment tools such as the Montreal Cognitive Assessment (MoCA) are essential for diagnosis. Imaging studies, including MRI, PET, and SPECT, reveal structural and functional brain alterations. Potential biomarkers include C-reactive protein, interleukin-6, and neuron-specific enolase. Management strategies encompass cognitive rehabilitation, occupational therapy, medications, and lifestyle modifications.</p>. <p>Long-COVID poses a multifaceted challenge, and cognitive impairment significantly impacts patients&rsquo; lives. A multi&shy;disciplinary approach, including cognitive rehabilitation and medication when appropriate, is essential for effective management. Future research should focus on validating biomarkers and understanding long-term cognitive outcomes.</p> <p>Conclusion &ndash; Long-COVID is a global health concern, and cognitive impairment is a distressing symptom. While pharmacological interventions have potential, they require careful consideration. Continued research is crucial for improving the understanding and treatment of cognitive impairment in long-COVID.</p>.

Why do individuals with Williams syndrome or Down syndrome fail the Weather Prediction Task?

Williams syndrome (WS) and Down syndrome (DS) are two neurodevelopmental disorders with distinct genetic origins characterized by mild to moderate intellectual disability. Individuals with WS or DS exhibit impaired hippocampus-dependent place learning and enhanced striatum-dependent spatial response learning. Here, we used the Weather Prediction Task (WPT), which can be solved using hippocampus- or striatum-dependent learning strategies, to determine whether individuals with WS or DS exhibit similar profiles outside the spatial domain. Only 10% of individuals with WS or DS solved the WPT. We further assessed whether a concurrent memory task could promote reliance on procedural learning to solve the WPT in individuals with WS but found that the concurrent task did not improve performance. To understand how the probabilistic cue-outcome associations influences WPT performance, and whether individuals with WS or DS can ignore distractors, we assessed performance using a visual learning task with differing reward contingencies, and a modified WPT with unpredictive cues. Both probabilistic feedback and distractors negatively impacted the performance of individuals with WS or DS. These findings are consistent with deficits in hippocampus-dependent learning and executive functions, and reveal the importance of congruent feedback and the minimization of distractors to optimize learning in these two populations.

Understanding the Neuropsychological Implications of Klinefelter Syndrome in Pediatric Populations: Current Perspectives.

Klinefelter syndrome (KS), also known as 47,XXY, is a genetic disorder characterized by the presence of an extra X chromosome. Despite the prevalence of verbal learning disabilities, memory impairments, and executive function deficits in individuals with KS, comprehensive research on the neuropsychological profiles of affected children and adolescents remains limited. Additionally, KS has been associated with comorbid conditions such as depression, anxiety, schizophrenia, attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorders (ASDs). However, systematic investigations into the neuropsychological manifestations of KS in pediatric populations are scarce. Therefore, the primary objectives of this review are to provide an overview of key studies examining the neuropsychological profiles of children and adolescents with KS and to delineate the limitations and implications of existing research findings. By synthesizing available literature, this review aims to bridge the gap in understanding the cognitive and behavioral characteristics of children and adolescents with KS, shedding light on potential avenues for future research and clinical interventions. Ultimately, this review serves as a valuable resource for clinicians, researchers, policymakers, parents, and educators involved in the assessment and management of the neuropsychological aspects of Klinefelter syndrome in pediatric populations.

Reducing Driving Risk Factors in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD): Insights from EEG and Eye-Tracking Analysis.

Adolescents with attention deficit hyperactivity disorder (ADHD) face significant driving challenges due to deficits in attention and executive functioning, elevating their road risks. Previous interventions targeting driving safety among this cohort have typically addressed isolated aspects (e.g., cognitive or behavioral factors) or relied on uniform solutions. However, these approaches often overlook this population's diverse needs. This study introduces the "Drive-Fun" innovative intervention (DFI), aimed at enhancing driving skills among this vulnerable population. The intervention was tested in a pilot study including 30 adolescents aged 15-18, comparing three groups: DFI, an educational intervention, and a control group with no treatment. Assessments included a driving simulator, EEG, and Tobii Pro Glasses 2. Evaluation was conducted pre- and post-intervention and at a 3-month follow-up. Results indicated that the DFI group significantly improved in the simulated driving performance, attentional effort, and focused gaze time. The findings underscore that holistic strategies with personalized, comprehensive approaches for adolescents with ADHD are particularly effective in improving driving performance. These outcomes not only affirm the feasibility of the DFI but also highlight the critical role of sensor technologies in accurately measuring and enhancing simulator driving performance in adolescents with ADHD. Outcomes suggest a promising direction for future research and application.