Improving Executive Functions Research Articles

Improving Executive Function and Dual-Task Cost in Parkinson Disease: A Randomized Controlled Trial.

Dual-task walking is challenging for people with Parkinson disease (PD). Gait performance worsens while executing dual tasks, possibly due to a decline in executive function (EF). This study aimed to investigate the effects of dual-task training on EF and dual-task cost (DTC) in people with PD and to explore whether training-induced changes in EF were associated with changes in DTC. This study was a randomized controlled trial. A total of 28 people with PD participated. Participants were randomly assigned to the experimental group (dual-task training) and the control group (treadmill training). Both groups received a total of 16 training sessions during the 8weeks. Assessments were conducted at baseline and postintervention. Primary outcomes included EF and dual-task cost. Significant time-by-group interactions were found in executive function and DTC. The experimental group showed significant improvement in frontal assessment battery (FAB), trail-making test (TMT) part A, Stroop color and word test (SCWT), and DTC on speed in cognitive dual-task walking. There was a moderate to high correlation between the change values of the FAB, TMT part A, SCWT, and the change values of DTC in cognitive dual-task walking. Compared to treadmill training, dual-task training resulted in greater improvements in EF and DTC. Training-induced changes in EF were linked to changes in DTC when walking while performing a cognitive task but not when walking while performing a motor task. For more insights from the authors Supplemental Digital Content available at http://links.lww.com/JNPT/A485.

Ecological Momentary Intervention to Replace Sedentary Time With Physical Activity to Improve Executive Function in Midlife and Older Latino Adults: Pilot Randomized Controlled Trial.

Exercise interventions often improve moderate to vigorous physical activity, but simultaneously increase sedentary time due to a compensatory resting response. A higher level of sedentary time is associated with a lower level of executive function, while increased moderate to vigorous physical activity is associated with improved global cognition and working memory among Latino adults. Latino adults are the fastest-growing minority group in the United States and are at high risk for cognitive decline, spend more time sedentary compared to non-Hispanic populations, and engage in low levels of physical activity. Interventions that are culturally appropriate for Latino adults to replace sedentary time with physical activity are critically needed. This study aims to develop and test the feasibility and acceptability of an ecological momentary intervention (EMI; delivered in real time) that is individually designed to replace sedentary time with physical activity in Latino adults. This pilot study randomized 39 (n=26, 67% female; mean age 61, SD 5.8 years) community-dwelling, Spanish-speaking Latino adults (1:1 allocation) to either a 6-week EMI program designed to replace sitting time with physical activity (20/39, 51%) or physical activity guidelines education (19/39, 49%). The program was conducted on the web and in Spanish. The intervention was individualized based on individual interview responses. The intervention included the use of a Fitbit activity monitor, weekly didactic phone meetings, interactive tools (SMS text messages), and coach-delivered feedback. Feasibility and acceptability were assessed via study satisfaction (Likert scales), motivation (ecological momentary assessment), retention, and compliance. Sedentary time and physical activity were assessed via 7-day actigraphy. Cognitive performance was assessed via the trail making test part A and B (part B=executive function) and via the National Institutes of Health Toolbox remote cognitive assessment. Statistical analysis included a linear model on change score from baseline, adjusting for age, sex, and education, emphasizing effect size. Participant satisfaction with EMI was high (9.4/10), with a high degree of motivation to replace sitting time with physical activity (9.8/10). The intervention compliance rate was 79% with low difficulty using the Fitbit (1.7/10). Weekly step count increased in the intervention group by 5543 steps (group difference: d=0.54; P=.05) and sedentary time decreased by a mean 348 (SD 485) minutes (group difference: d=0.47; P=.24) compared to controls, with moderately strong effect sizes. The trail making test part B improved in the intervention group (mean -35.26, SD 60.35 seconds), compared to the control group (mean 7.19, SD 46 seconds; group difference: d=0.74; P=.01). No group differences were observed in other cognitive measures. An individualized EMI designed for midlife and older Latino adults has the potential to replace sitting time with physical activity and improve executive functioning. The intervention was feasible and well received with a high degree of satisfaction. ClinicalTrials.gov NCT04507464; https://tinyurl.com/44c4thk5.

AWAKE School Intervention Program: Improving Executive Functions and Reducing Social and Emotional Difficulties in School-Aged Children

This paper reports the results from a school-based intervention for primary and elementary children evaluating the AWAKE project. The AWAKE intervention is a universal program that can be applied by teachers and is designed to improve children’s executive functions and well as their social and emotional well-being. 141 children aged from 6 to 14 from Romania and Austria were involved in the study and 50 teachers implemented the intervention. Out of the 141 children 37 of them had some learning difficulties, 25 children had a difficult social background, and 39 of them had some social and emotional problems as identified by their teachers. The intervention program lasted for 10 weeks with sessions implemented twice a week. Our results showed that children improved their working memory, inhibitory control, planning and behaviour regulation. Moreover, they showed great reduction of their emotional problems, as well as decreased behaviour problems and increased social behaviours. Future studies should investigate the potential of such activities for improving children’s academic performance, as well as the benefits of including them in the school curriculum.

Effects of Executive Functions Training in Primary School Students with Borderline Intellectual Functioning Through a Multi-Method, Multi-Informant Intervention: A Pilot Study.

Borderline Intellectual Functioning (BIF) impacts cognitive functioning and adaptive behavior. Recent studies have demonstrated the efficacy of Executive Functions trainings to support daily-living skills in several clinical populations. However, although the relationship between Executive Functions and BIF has been studied, few studies have explored the effects of cognitive enhancement training for BIF children. Given the pivotal significance of Executive Functions in learning, orchestrating cognitive processes, and modulating affective and behavioral responses, our study aimed to evaluate the efficacy of cognitive enhancement training targeting Executive Functions in a group of 23 children diagnosed with Borderline Intellectual Functioning devoid of neurodevelopmental impairments. We included a multiple assessment based on several informants (children, teachers, parents, and tutors) and provided individualized cognitive enhancement training focused on Executive Functions through both digital and analog activities. The training was highly customized, structured and monitored at various stages of the process activities. The training was composed of 20 sessions, each lasting 2 hours, held twice a week for each child. The obtained results confirmed the efficacy of cognitive enhancement training in improving Executive Functions, the primary target of the intervention, particularly in attention, verbal fluency, planning, inhibitory control, working memory, and flexibility. Furthermore, improvements were observed by all the informants in other cognitive functions, learning, and adaptive behaviors. Our study contributes to the understanding of BIF, emphasizing the efficacy of neuropsychological enhancement through personalized training for EF.

Efficacy of Cognitive Behavioral Intervention in Improving Executive Function of Children with High Functioning Autism Spectrum Disorder: A Meta-analysis

This meta-analysis examines the efficacy of the cognitive behavioral approach to interventions toward the improvement of executive function for children/adolescents with high-functioning autism spectrum disorder (HF-ASD). This meta-analysis paper has identified ten studies involving 437 participants with high-functioning autism spectrum disorder aged between 5 and 18. All the participants reported IQs were at or above 70. A random effect meta-analysis yielded a moderately significant effect (Hedge g = 0.72) with significant heterogeneity [Q(10) = 228.36, p < .001]. There were considerable variations in the executive function domain, i.e., working memory (hedge g = 1.23) and inhibition (g = 0.47), showing significant treatment effects. On the other hand, cognitive flexibility (g = -0.51) and planning (g = -0.07) show non-significant effects toward cognitive behavioral interventions. The finding suggests that the cognitive behavioral approach to intervention demonstrates efficacy in improving executive function in children or adolescents with high-functioning autism spectrum disorder. All the cognitive behavioral intervention studies were conducted in developed countries, so differences between the approaches between developed and developing countries were inconclusive. Future studies are needed to investigate the effectiveness of cognitive behavioral techniques in intervention for low-functioning autism spectrum disorder children.

Effects of Commercial Exergames and Conventional Exercises on Improving Executive Functions in Children and Adolescents: Meta-Analysis of Randomized Controlled Trials.

Exergames are promising exercise tools for improving health. To the best of our knowledge, no systematic review has compared the effects of commercial exergames and conventional exercises on improving executive functions (EFs) in children and adolescents. This study aimed to investigate the effects of commercial exergames and conventional exercises on improving EFs in children and adolescents. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 5 randomized controlled trial (RCT) databases (PubMed, Web of Science, Scopus, PsycINFO, and SPORTDiscus) were searched from their inception to July 7, 2022, to identify relevant RCTs. The Cochrane Collaboration tool was used to evaluate the risk of bias for each study. GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) was used to evaluate the overall quality of evidence. In total, 8 RCTs including 435 children and adolescents were included in the analysis. Commercial exergames had no significant benefit on overall EFs compared to conventional exercises (Hedges g=1.464, 95% CI -0.352 to 3.280; P=.06). For core EFs, there was no evidence to suggest that commercial exergames are more beneficial for improving cognitive flexibility (g=0.906, 95% CI -0.274 to 2.086; P=.13), inhibitory control (g=1.323, 95% CI -0.398 to 3.044; P=.13), or working memory (g=2.420, 95% CI -1.199 to 6.038; P=.19) than conventional exercises. We rated the evidence for overall EFs, cognitive flexibility, inhibitory control, and working memory as being of very low quality due to inconsistency (large heterogeneity) and imprecision (low number of people). Additionally, no effects of the intervention were observed in the acute and chronic groups. We do not have strong evidence to support the benefit of commercial exergaming on EFs because we did not observe a Hedges g close to 0 with tight CIs. Further research is needed to confirm this hypothesis. PROSPERO CRD42022324111; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=324111.

Can Interacting with Animals Improve Executive Functions? A Systematic Review

There has been growing interest in the potential benefits of using human–animal interactions to improve executive functions: cognitive processes that allow individuals to plan, solve problems, and self-regulate behaviour. To date, no comprehensive review has been conducted. The purpose of this study was to evaluate existing literature, adopting broad inclusion criteria. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 16 papers were identified from peer-reviewed literature. Additional papers were identified from grey literature, including 6 dissertations and 1 thesis. A review of these 23 studies found that human–animal interactions and executive functions are investigated in three main ways: (1) exploring the potential benefits of the human–pet relationship, (2) exploring the impact of an animal’s presence during administration of executive function tests, and (3) evaluating the efficacy of animal-assisted services (e.g., animal-assisted therapy) on executive functions. Five of the included studies reported a significant improvement across all measured domains of executive functions, but effect sizes were underreported. Comparatively, 9 studies reported mixed findings, d = 0.32–0.55, while 8 studies reported no significant results. The overall rigour of the research was limited, with great heterogeneity between the study methodologies and outcome measures used. It is recommended that future studies utilise high-quality research methodologies through the use of randomisation, pre- and postmeasures, and appropriate control conditions, where possible.

Can Virtual Reality Cognitive Rehabilitation Improve Executive Functioning and Coping Strategies in Traumatic Brain Injury? A Pilot Study

Executive dysfunction is among the most common and disabling facets of cognitive impairment following traumatic brain injury (TBI), and may include deficits in reasoning, planning, mental flexibility, some aspects of attention and orientation, awareness and behavior. Rehabilitation programs based on cognitive-behavioral approaches to retrain planning and problem-solving and other executive deficits may improve such cognitive dysfunction. The purpose of this study is to investigate the effects of non-immersive virtual reality-based training to improve executive abilities and to reduce anxiety and depression symptoms in patients with TBI. Twenty patients with moderate to severe TBI were enrolled at our Neurorehabilitation Unit and divided to receive either the standard cognitive training or the virtual reality (VR) based cognitive training using the virtual reality rehabilitation system (VRRS-Evo). Each group received the same amount of rehabilitative training, including ROT (Reality Orientation Therapy) and Executive Training (ET), but using a different approach, i.e., a paper and pencil and an advanced approach. All patients were evaluated with a specific psychometric battery before (T0) and after the end (T1) of each program. Comparing pre- and post- treatment scores, in the VR-CT group, we found statistically significant differences in all administered outcome measures for cognitive and executive functioning, i.e., MoCA (p < 0.005), FAB (p < 0.005), TMT-A (p < 0.005), TMT-B (p < 0.005), TMT-BA (p < 0.001), and mood, i.e., HRS-D (p < 0.008). In the Conventional cognitive training (C-CT) group, we found a significant improvement only in MoCA (p < 0.03), FAB (p < 0.02) and in TMT-BA (p < 0.01). Coping strategies also improved, with better results in the VR-CT group. Our results suggest that VR rehabilitation, using the VRRS system, may be a valuable and motivational approach to improve visuo-executive abilities and coping strategies as well as mood in chronic TBI patients.

Improving Executive Functions Using the Engineering Design Process: A Peer-Mediated Problem-Solving Approach for Autistic Adolescents

Executive functions-specifically, problem-solving skills-are crucial for school success. Challenges in these functions faced by autistic adolescents are often unrecognized or viewed through a behavioral lens that requires correction or normalization. A lack of development of higher order problem-solving skills leads to increased instances of secondary mental health issues, creating further behavioral and social challenges. We propose using the Engineering Design Process (EDP), a flexible, cyclical, top-down, self-sustaining approach that uses peer mediation to teach group problem-solving skills. We then position this cycle within existing occupational therapy models to demonstrate its adaptability and flexibility, describe the distinct features of this problem-solving strategy, and present a real-world case study in which the EDP is used as a problem-solving approach in an after-school program. The EDP develops crucial social and interpersonal skills using interest-driven occupations and can be organically used as a group strategy. This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel etal., 2021, Kenny etal., 2016).

3.24 Exergaming Using Obie® and its Effect in Improving Executive Function Deficits in Children With Fetal Alcohol Spectrum Disorder and Comorbid ADHD: An Exploratory Study

We conducted an exploratory study aimed to investigate if repeated exercise sessions (12 sessions; twice a week for 6 weeks) using the OBIE® Interactive Exergaming Platform would improve executive functions and aerobic fitness (VO2max) in children and adolescents with fetal alcohol spectrum disorders (FASD) and comorbid ADHD. Through this novel, innovative “gamified” exercise, it was hypothesized that the participants would demonstrate improvements in aerobic fitness and executive functions.

Dual-Task-Based Music Therapy to Improve Executive Functioning of Elderly Patients with Early Stage Alzheimer's Disease: A Multiple Case Study.

Deficits in executive functioning are a common feature of Alzheimer’s disease (AD) and result from impairment in the central executive system. As a result, elderly patients with early stage AD may require interventions that are more cognitively intense than traditional interventions. To address this need, in this multiple case study, we explored a dual-task-based music therapy intervention that involved drum playing and singing designed to induce attentional and motor controls. Three octogenarians diagnosed with early stage AD participated in 12 dual-task-based music therapy sessions over 6 weeks. Measures of executive functioning and the performance of a bimanual drum tapping task were evaluated before and after the intervention. Improvements in executive functioning were observed for participants A and C. After the intervention, reduced mean synchronization errors were found for the simultaneous tapping condition for all three participants. Although there was variability in the functional changes between participants, it is noteworthy that positive improvements in the elderly patients with early stage AD were obtained following dual-task-based music therapy. The results suggest that music therapy integrated into the dual-task paradigm can be an effective way to address degenerative cognitive deficits among elderly patients with early stage AD.

Short Duration Simulated Microgravity Models Improve Executive Function

PURPOSE: To determine whether executive function is altered during two variations of simulated microgravity head down tilt protocols. METHODS: 26 healthy volunteers (n=19 females and 7 males; 20.0 ± 1.7 years; 165.6 ± 24.5 cm; 71.1 ± 15.9 kg; mean±SD) took part in two randomly assigned separate simulated microgravity sessions consisting of 1.5 hours at -6° head down tilt (HDT) sessions. Each testing session lasted approximately 2.5 hours. One session consisted of the broadly used -6° HDT facing up (HDT-FU), while the other consisted of a -6° HDT facing down (HDT-FD) modification of the standard method. For each condition, the participant completed a computerized Stroop Color and Word Test during a thirty-minute horizontal position (0° tilt) prior to the interventions and again prior to the end of the 1.5-hour HDT protocols. The Stroop Color and Word Test consisted of 3 tasks (60 trials per task) including: 1) a Naming task, 2) an Inhibition task, and 3) an Inhibition/Switching task. To minimize the learning effect, both the HDT-FU and HDT-FD sessions were counterbalanced amongst all participants and were separated by a minimum of 48 hours. RESULTS: Our cognitive reaction time results demonstrate a main effect of time (pre HDT 777.60 ± 18.08ms vs post HDT 749.30 ± 19.11ms, p<0.01) and a main effect of Stroop Test (Naming < Inhibition < Inhibition/Switching, p<0.01). Additionally, we observed that the 1.5-hour protocol selectively improved the Inhibition/Switching reaction times (the most executive component) for both the HDT-FU (pre HDT-FU 945.68 ± 32.87ms vs post HDT-FU 903.16 ± 33.78ms, p=0.02) and HDT-FD (pre HDT-FD 961.25 ± 38.55ms vs post HDT-FD 868.91 ± 30.40ms, p<0.01). CONCLUSION: When executive demand is increased under short-term simulated microgravity head down tilt conditions, regardless of the position (face up or face down), cognitive reaction time is decreased, suggesting an improvement in overall cognitive function.

Effectiveness of Serious Games for Improving Executive Functions Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis.

BackgroundExecutive functions are one of the known cognitive abilities that decline with age. They are the high-order cognitive processes that enable an individual to concentrate, plan, and take action. Serious games, which are games developed for specific purposes other than entertainment, could play a positive role in improving executive functions. Several systematic reviews have pooled the evidence about the effectiveness of serious games in improving executive functions; however, they are limited by some weaknesses.ObjectiveThis study aims to investigate the effectiveness of serious games for improving executive functions among older adults with cognitive impairment.MethodsA systematic review of randomized controlled trials (RCTs) was conducted. To retrieve relevant studies, 8 electronic databases were searched. Further, reference lists of the included studies and relevant reviews were screened, and we checked studies that cited our included studies. Two reviewers independently checked the eligibility of the studies, extracted data from the included studies, assessed the risk of bias, and appraised the quality of the evidence. We used a narrative and statistical approach, as appropriate, to synthesize results of the included studies.ResultsOf 548 publications identified, 16 RCTs were eventually included in this review. Of the 16 studies, 14 studies were included in 6 meta-analyses. Our meta-analyses showed that serious games are as effective as no or passive interventions at improving executive functions (P=.29). Surprisingly, conventional exercises were more effective than serious games at improving executive functions (P=.03). Our subgroup analysis showed that both types of serious games (cognitive training games, P=.08; exergames, P=.16) are as effective as conventional exercises at improving executive functions. No difference was found between adaptive serious games and nonadaptive serious games for improving executive functions (P=.59).ConclusionsSerious games are not superior to no or passive interventions and conventional exercises at improving executive functions among older adults with cognitive impairment. However, our findings remain inconclusive due to the low quality of the evidence, the small sample size in most included studies, and the paucity of studies included in the meta-analyses. Accordingly, until more robust evidence is available, serious games should not be offered by health care providers nor used by patients for improving executive functions among older adults with cognitive impairment. Further reviews are needed to assess the long-term effect of serious games on specific executive functions or other cognitive abilities among people from different age groups with or without cognitive impairment.Trial RegistrationPROSPERO CRD42021272757; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=272757

Cognitive Rehabilitation Training in Improving Executive Function, Antisocial Behaviors, and Legal Problems in Children With Attention-Deficit/Hyperactivity Disorder

Background:Attention Deficit Disorder/Attention-Deficit/Hyperactivity Disorder (ADD/ ADHD) is one of the most prevalent childhood diseases, and it may substantially influence social behaviors, legal issues, and disputes. The goal was to see how cognitive rehabilitation training affected executive functioning and impulsivity in children with ADHD in Tehran, District 5. Methods: A quasi-experimental design was used, with two groups (experimental and control) and a pretest-posttest. All students with ADHD disorder aged 7 to 12 years were included in the statistical population. The sample comprised 30 kids who were age-matched and randomly split into two groups. They were tested for two months in February and March 2021. Slow cognitive rehabilitation training was given to the experimental group. Both groups were given a pretest and a posttest. Information was gathered using the BRIEF (parent form) and Conners’ (parent form) questionnaires. MANCOVA was used to analyze the data, using the SPSS software v. 26, with a significance threshold of 0.05. Results: There was a significant difference in executive function variables (inhibition, attention transfer, emotional control, initiation, working memory, planning, material organization, and control) and reduced impulsivity (attention deficit , hyperactivity, opposition, and ADHD) (P≤0.001). Conclusion: Cognitive rehabilitation improves executive skills and impulsivity in children with ADHD aged 7-12 years. Cognitive rehabilitation training should be utilized with other educational approaches to rectify social behaviors, minimize conflict, and improve executive functions.

Comparison of the Effectiveness of Pharmacotherapy and Neurofeedback on Improving Executive Functions in Children with Attention Deficit-Hyperactivity Disorder

Comparison of the Effectiveness of Pharmacotherapy and Neurofeedback on Improving Executive Functions in Children with Attention Deficit-Hyperactivity Disorder

Taper Off Treatment Can Improve Executive Functions and Regulate Expression of BDNF and 5HTTPLR Genes in Opium Abusers after Six Months Period

Opium is the dried latex obtained from the opium poppy. Opium addiction is the most prevalent addiction in Iranian society. During the last two decades "congress 60" a nongovernmental organization, has been performed a taper off treatment of opium associated with a package of psychological treatment group classes. While the effectiveness of taper off method in opium addiction has been confirmed, molecular mechanisms of this treatment in addicts are not clarified. BDNF gene is a brain-derived neurotrophic factor which is related to several molecular mechanisms of the brain including memory. 5-HTTPLR is a transporter of serotonin that is related to the decision-making process. In present study mRNA level of BDNF and 5-HTTPLR genes in peripheral blood of 20 non-psychiatric persons and 79 opium addicted individuals before and after six months period of taper off treatment was examined by using Real-Time PCR and confirmed by protein level analysis using Western blotting. In addition, executive functions including memory and decision making were analyzed in all participants. Results showed significant down expression of BDNF and 5-HTTPLR in addict persons vs. non psychiatric persons. Also significantly increase detected in BDNF (p&lt;0.01) and5-HTTPLR (p&lt;0.01) expression level in addicts after six months of therapy period. Similar results with gene expression results revealed in protein level analysis. Also, significant improvements in memory and decision making were revealed in addicts after therapy and these improvements were correlated with the expression level of BDNF and 5-HTTPLR. Findings revealed the effect of opium abuse and taper off treatment on the expression of BDNF and 5-HTTPLR. In addition, the association of BDNF mRNA level with psychological states of addict's individuals detected. Results of the present study may help to a better understanding of molecular and neuropsychological mechanisms of opium addiction and taper off treatment. Also, present BDNF and 5-HTTPLR as potential markers for screening the effectiveness of different kinds of addiction treatment.

Comparison of the Effectiveness of Virtual Reality-based Cognitive Rehabilitation With Classical Cognitive Rehabilitation on Improving Executive Function in Children with Attention Deficit-Hyperactivity Disorder

Background and Aim: Children with Attention Deficit Hyperactivity Disorder are a good target group for cognitive rehabilitation Because their behavioral problems, including inattention, impulsivity, and hyperactivity, have a specific cognitive and cerebral origin. This adaptation of behavior to cognitive function provides an opportunity to repair behavior by strengthening cognitive function. This study aimed to compare the effectiveness of cognitive rehabilitation based on virtual reality technology as a new method and classical cognitive rehabilitation in improving the executive functions of children with attention deficit hyperactivity disorder. Methods &amp; Materials: This research was a quasi-experimental study using a pre-test-post-test design with a control group. The statistical population included all children aged 7-12 years with Attention Deficit Hyperactivity Disorder in Tehran in 1398 who were selected by convenience sampling method and randomly divided into 3 groups of 12 people. In the pre-test stage, participants were assessed with the Attention Deficit Hyperactivity Disorder Rating Scale and the Computer Integrated Visual and Auditory Test (IVA-2). The first group received a virtual reality-based cognitive rehabilitation package and the second group received a Captain Log computer cognitive rehabilitation package, 12 sessions twice a week. No intervention was performed in the control group during this period. Post-tests were taken from all 3 groups after the intervention. Univariate analysis of covariance (ANCOVA) was used to analyze the data using SPSS software v. 26. Ethical Considerations: This study was approved by the Research Ethics Committee of the Islamic Azad University, Central Tehran Branch (Code: IR.IAU.CTB.REC.1400.001). Results: The results showed that both methods of cognitive rehabilitation intervention had a significant effect on cognitive functions (selective attention, sustained attention) of Attention deficit hyperactivity disorder (ADHD) children (P&lt;0.01). But no significant difference was observed between the mean scores of selective attention and sustained attention in the first experimental group and the second experimental group (P&gt;0.05). Conclusion: Virtual reality-based cognitive rehabilitation is as effective as classical cognitive rehabilitation on selective attention and sustained attention in children with ADHD. Virtual reality-based cognitive rehabilitation can be used as a new approach to rehabilitating this disorder.

Improved Executive Functions and Reduced Craving in Youths with Methamphetamine Addiction: Evidence from Combined Transcranial Direct Current Stimulation with Mindfulness Treatment.

ObjectiveTranscranial direct current stimulation (tDCS) and mindfulness practices have been proposed as a potential approach to improve executive functions (EFs) and reduce craving in persons with substance use disorders. Based on the neural mechanisms of action of each of these interventions, the combination of both non-pharmacological interventions might have additive effects. In the current study, the effects of tDCS combined with mindfulness-based substance abuse treatment (MBSAT) to improve EFs and reduce craving were investigated in early abstinent methamphetamine abuse.MethodsEighty (youths aged between 18 and 21) early-abstinent methamphetamine users were randomly assigned to the research groups (tDCS group [n = 20], mindfulness group [n = 20], combined mindfulness-tDCS group [n = 20], and sham group [n = 20]). Active tDCS (1.5 mA,20 min, 12 sessions) or sham tDCS was appliedover the left dorsolateral prefrontal cortex and the MBSAT protocol was used over twelve 50-min sessions.ResultsBoth in the post-test phase (immediately after the intervention) and follow-up phase (one month after the intervention), performance in most EFs tasks significantly improved in the combination group which received real tDCS ＋ MBSAT, as compared to baseline values and sham stimulation group. Similarly, a significant reduction in craving was observed after intervention inall treatment groups, but not the sham stimulation group. Interestingly, the increase in EFs and the reduction in craving post versus pre tDCS ＋ MBSAT intervention were correlated.ConclusionFindings from the current study provide initial support for the clinical effectiveness of combination tDCS ＋ MBSAT, possibly influencing cognitive/affective processes.

A Randomized Controlled Trial on the Efficacy of PositivePsychotherapy on Improving Executive Function and Plasma Cortisol Levels in Patients with Anxiety

Interoduction: Anxiety among students can lead to decreased performance and may be associated with other psychological and biological consequences. Therefore, it deserves clinical attention. On the other hand, reinforcing positive resources such as feelings, behaviors, and positive cognitions can be used as an important intervention in managing and improving mood disorders. This study evaluated the efficacy of positive psychotherapyon improving executive function and modulating serum cortisol levels in patients with anxiety.Method: In a randomized controlled clinical trial, 30 students with anxiety symptoms were selected using purposive sampling method and were assigned to experimental and control groups through block randomization method after confirming entry criteria. The intervention was presented to the experimental group in a positive approach for ten weekly sessions and the control group was placed on the waiting list. Changes in the executive functions index were considered as primary outcomes and serum cortisol levels fluctuations were considered as secondary outcomes. Data were analyzed by multivariate analysis of covariance in SPSS 21 software. Result: Primary outcomesshowed that ten weeks of positive therapy had a significant effect on improvement of executive function (p<0.001). Secondary outcomes also showed that positive psychotherapy was effective in decreasing serum cortisol levels (p<0.001).Conclusion: Results showed that positive psychotherapy had a significant effect on the improvement of executive function and reducing serum cortisol levels. These findings demonstrate the effectiveness of psychotherapy on the prefrontal cortex (PFC)and its interaction with the hypothalamic–pituitary–adrenal (HPA) axis function.Declaration of Interest: None.Declaration of Interest: None

Perceptual-Motor Skills Reconstruction Program Improves Executive Functions in Children with Attention-Deficit/Hyperactivity Disorder

Objective: Many children suffering from attention-deficit/hyperactivity disorder (ADHD) show problems in executive functions (EF), which reflect neuronal pathways from perception to controlled action. Treatment approaches that improve executive functions may prevent a negative cycle of failures in students. Hence, this research aims to study the efficacy of the perceptual-motor skills reconstruction program on EF in children with ADHD while considering cognitive flexibility, abstract verbal skills, response inhibition, and working memory. Also, its effect on clinical ADHD symptoms should be considered. Method: The research design included pretest, posttest, and a follow-up after six months. The sample included third-grade school children with ADHD (50 students, aged 8–10 years, boys and girls) who were referred to the Child Psychology Clinic, Iran, Mashhad 2018–2019. After clinical assessment for ADHD, children were randomly assigned to an experimental (n = 25) and a waiting control (n = 25) group. The experimental group received the perceptual-motor skills reconstruction program for 16 sessions (three times per week, i.e., five weeks and one session in the sixth week). Delis–Kaplan executive function system (D-KEFS) was applied at three measurement points (M1–3) in order to test for changes over time. Results: Data analysis (analysis of covariance (ANCOVA) with post-hoc-testing) showed that there was a significantly better performance of experimental versus waiting control group at posttest (M2) and follow-up (M3) for cognitive flexibility (t(24) = 4.9, df = 14, p &lt; 0.0001), abstract verbal skills (t(24) = 3.5, df = 14, p &lt; 0.004), response inhibition (t(24) = 7.54, df = 14, p &lt; 0.0001) and working memory (t(24) = 12.69, df = 14, p &lt; 0.004). Further, Conners-Scales-Score improved for the experimental group. Conclusions: Training with perceptual-motor skills reconstruction program clearly improved the trained variables (i.e., cognitive flexibility, abstract verbal skills, response inhibition, and working memory) and clinical symptoms of the children with ADHD. The obtained training may lead in practice to better preconditions for successfully handling daily tasks at school and in society.