scholarly journals Effects of methylphenidate on executive functioning in attention-deficit/hyperactivity disorder across the lifespan: a meta-regression analysis

2016 ◽  
Vol 46 (9) ◽  
pp. 1791-1807 ◽  
Author(s):  
H. G. H. Tamminga ◽  
L. Reneman ◽  
H. M. Huizenga ◽  
H. M. Geurts
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Working Memory ◽  
Sustained Attention ◽  
Response Inhibition ◽  
Attention Deficit ◽  
Animal Studies ◽  
Meta Analysis ◽  
Double Blind ◽  
Hyperactivity Disorder ◽  
Age Related

Attention-deficit/hyperactivity disorder (ADHD) in childhood and adulthood is often treated with the psychostimulant methylphenidate (MPH). However, it is unknown whether cognitive effects of MPH depend on age in individuals with ADHD, while animal studies have suggested age-related effects. In this meta-analysis, we first determined the effects of MPH on response inhibition, working memory and sustained attention, but our main goal was to examine whether these effects are moderated by age. A systematic literature search using PubMed, PsycINFO, Web of Science and MEDLINE for double-blind, placebo-controlled studies with MPH resulted in 25 studies on response inhibition (n = 775), 13 studies on working memory (n = 559) and 29 studies on sustained attention (n = 956) (mean age range 4.8–50.1 years). The effects of MPH on response inhibition [effect size (ES) = 0.40, p < 0.0001, 95% confidence interval (CI) 0.22–0.58], working memory (ES = 0.24, p = 0.053, 95% CI 0.00–0.48) and sustained attention (ES = 0.42, p < 0.0001, 95% CI 26–0.59) were small to moderate. No linear or quadratic age-dependencies were observed, indicating that effects of MPH on executive functions are independent of age in children and adults with ADHD. However, adolescent studies are lacking and needed to conclude a lack of an age-dependency across the lifespan.

scholarly journals Disruptions of working memory and inhibition mediate the association between exposure to institutionalization and symptoms of attention deficit hyperactivity disorder

2015 ◽  
Vol 46 (3) ◽  
pp. 529-541 ◽  
Author(s):  
F. Tibu ◽  
M. A. Sheridan ◽  
K. A. McLaughlin ◽  
C. A. Nelson ◽  
N. A. Fox ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Working Memory ◽  
Response Inhibition ◽  
Attention Deficit ◽  
Early Deprivation ◽  
Institutionalized Children ◽  
Memory Response ◽  
Hyperactivity Disorder ◽  
History Of ◽  
And Gender

BackgroundYoung children raised in institutions are exposed to extreme psychosocial deprivation that is associated with elevated risk for psychopathology and other adverse developmental outcomes. The prevalence of attention deficit hyperactivity disorder (ADHD) is particularly high in previously institutionalized children, yet the mechanisms underlying this association are poorly understood. We investigated whether deficits in executive functioning (EF) explain the link between institutionalization and ADHD.MethodA sample of 136 children (aged 6–30 months) was recruited from institutions in Bucharest, Romania, and 72 never institutionalized community children matched for age and gender were recruited through general practitioners’ offices. At 8 years of age, children's performance on a number of EF components (working memory, response inhibition and planning) was evaluated. Teachers completed the Health and Behavior Questionnaire, which assesses two core features of ADHD, inattention and impulsivity.ResultsChildren with history of institutionalization had higher inattention and impulsivity than community controls, and exhibited worse performance on working memory, response inhibition and planning tasks. Lower performances on working memory and response inhibition, but not planning, partially mediated the association between early institutionalization and inattention and impulsivity symptom scales at age 8 years.ConclusionsInstitutionalization was associated with decreased EF performance and increased ADHD symptoms. Deficits in working memory and response inhibition were specific mechanisms leading to ADHD in previously institutionalized children. These findings suggest that interventions that foster the development of EF might reduce risk for psychiatric problems in children exposed to early deprivation.

scholarly journals Drug-specific laterality effects on frontal lobe activation of atomoxetine and methylphenidate in attention deficit hyperactivity disorder boys during working memory

2013 ◽  
Vol 44 (3) ◽  
pp. 633-646 ◽  
Author(s):  
A. Cubillo ◽  
A. B. Smith ◽  
N. Barrett ◽  
V. Giampietro ◽  
M. Brammer ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Working Memory ◽  
Attention Deficit ◽  
Double Blind ◽  
Performance Deficits ◽  
Impaired Performance ◽  
Clinical Dose ◽  
Hyperactivity Disorder ◽  
Dorsolateral Prefrontal ◽  
And Performance

BackgroundThe catecholamine reuptake inhibitors methylphenidate (MPH) and atomoxetine (ATX) are the most common treatments for attention deficit hyperactivity disorder (ADHD). This study compares the neurofunctional modulation and normalization effects of acute doses of MPH and ATX within medication-naive ADHD boys during working memory (WM).MethodA total of 20 medication-naive ADHD boys underwent functional magnetic resonance imaging during a parametric WM n-back task three times, under a single clinical dose of either MPH, ATX or placebo in a randomized, double-blind, placebo-controlled, cross-over design. To test for normalization effects, brain activations in ADHD under each drug condition were compared with that of 20 age-matched healthy control boys.ResultsRelative to healthy boys, ADHD boys under placebo showed impaired performance only under high WM load together with significant underactivation in the bilateral dorsolateral prefrontal cortex (DLPFC). Both drugs normalized the performance deficits relative to controls. ATX significantly enhanced right DLPFC activation relative to MPH within patients, and significantly normalized its underactivation relative to controls. MPH, by contrast, both relative to placebo and ATX, as well as relative to controls, upregulated the left inferior frontal cortex (IFC), but only during 2-back. Both drugs enhanced fronto-temporo-striatal activation in ADHD relative to control boys and deactivated the default-mode network, which were negatively associated with the reduced DLPFC activation and performance deficits, suggesting compensation effects.ConclusionsThe study shows both shared and drug-specific effects. ATX upregulated and normalized right DLPFC underactivation, while MPH upregulated left IFC activation, suggesting drug-specific laterality effects on prefrontal regions mediating WM.

Efficacy, Acceptability, and Tolerability of Lisdexamfetamine, Mixed Amphetamine Salts, Methylphenidate, and Modafinil in the Treatment of Attention-Deficit Hyperactivity Disorder in Adults: A Systematic Review and Meta-analysis

2018 ◽  
Vol 53 (2) ◽  
pp. 121-133 ◽  
Author(s):  
Matej Stuhec ◽  
Petar Lukić ◽  
Igor Locatelli
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Clinical Trials ◽  
Effect Size ◽  
Attention Deficit ◽  
Data Extraction ◽  
Meta Analysis ◽  
Sole Source ◽  
Adhd Symptoms ◽  
Double Blind ◽  
Hyperactivity Disorder

Objective: Psychostimulants are the first-line treatment in adults with attention-deficit hyperactivity disorder (ADHD). This meta-analysis aimed to evaluate the efficacy, acceptability, and tolerability of lisdexamfetamine (LDX), mixed amphetamine salts (MASs), modafinil (MDF), and methylphenidate (MPH) in comparison with placebo. Data Sources: We systematically searched PubMed/MEDLINE and Clinicaltrials.gov in May 2016, along with CENTRAL and EU Clinical Trials Register in February 2016, for the randomized, double-blind, placebo-controlled, parallel-group clinical trials conducted on adults diagnosed with ADHD. Study Selection and Data Extraction: Substantial comorbidity, substance abuse or dependence, and nonpharmacological interventions represented grounds for exclusion. Published reports were the sole source for data extraction. Improvement in ADHD symptoms was the primary outcome. Random-effects model meta-analysis was applied to calculate the standardized mean difference (SMD) with 95% CIs. Data Synthesis: The search retrieved 701 records, of which 20 studies were eligible for analysis. High effect size (expressed as SMD) in reducing ADHD symptoms was observed for LDX (−0.89; 95% CI = −1.09, −0.70), whereas MASs (−0.64; 95% CI = −0.83, −0.45) and MPH (−0.50; 95% CI = −0.58, −0.41) reduced symptoms moderately compared with placebo. No efficacy was shown for MDF (0.08; 95% CI; −0.18, 0.34). Relevance to Patient Care and Clinical Practice: In this meta-analysis, the efficacy, tolerability, and acceptability of psychostimulants were compared with that for placebo. Five of the included trials have not been evaluated in any of the previously published meta-analyses. Conclusions: The results suggest that LDX has the largest effect size and has a promising potential for treating adults with ADHD.

scholarly journals A Review of Executive Functions in Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder

2018 ◽  
Vol 8 (2) ◽  
pp. 107
Author(s):  
Carmen Berenguer ◽  
Belen Rosello ◽  
Geraldine Leader
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Working Memory ◽  
Executive Functions ◽  
Children And Adolescents ◽  
Response Inhibition ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Hyperactivity Disorder

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are two of the most common childhood-onset neurodevelopmental disorders. Literature has shown different patterns of deficits in executive functioning in children with ASD and ADHD. To date few studies have examined executive functions in both ASD and ADHD and with mixed results.The current study provides the first systematic review to explore distinct executive function components (attention problems, response inhibition, working memory, planning and flexibility) that underlie the specific deficits seen in children and adolescents with both ASD and ADHD disorders. Findings provide evidence for executive dysfunctions across different key components such as attention, response inhibition and verbal working memory in children and adolescents with ASD and comorbid ADHD clinical symptoms. This research explores the neurocognitive profile of the comorbid condition, which is also critical for designing appropriate interventions.

Disorder-dissociated effects of fluoxetine on brain function of working memory in attention deficit hyperactivity disorder and autism spectrum disorder

2014 ◽  
Vol 45 (6) ◽  
pp. 1195-1205 ◽  
Author(s):  
K. Chantiluke ◽  
N. Barrett ◽  
V. Giampietro ◽  
M. Brammer ◽  
A. Simmons ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Working Memory ◽  
Attention Deficit ◽  
Brain Function ◽  
Repeated Measures ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Double Blind ◽  
Hyperactivity Disorder

Background.Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are often co-morbid and share performance and brain dysfunctions during working memory (WM). Serotonin agonists modulate WM and there is evidence of positive behavioural effects in both disorders. We therefore used functional magnetic resonance imaging (fMRI) to investigate shared and disorder-specific brain dysfunctions of WM in these disorders, and the effects of a single dose of the selective serotonin reuptake inhibitor (SSRI) fluoxetine.Method.Age-matched boys with ADHD (n = 17), ASD (n = 17) and controls (n = 22) were compared using fMRI during an N-back WM task. Patients were scanned twice, under either an acute dose of fluoxetine or placebo in a double-blind, placebo-controlled randomized design. Repeated-measures analyses within patients assessed drug effects on performance and brain function. To test for normalization effects of brain dysfunctions, patients under each drug condition were compared to controls.Results.Under placebo, relative to controls, both ADHD and ASD boys shared underactivation in the right dorsolateral prefrontal cortex (DLPFC). Fluoxetine significantly normalized the DLPFC underactivation in ASD relative to controls whereas it increased posterior cingulate cortex (PCC) deactivation in ADHD relative to control boys. Within-patient analyses showed inverse effects of fluoxetine on PCC deactivation, which it enhanced in ADHD and decreased in ASD.Conclusions.The findings show that fluoxetine modulates brain activation during WM in a disorder-specific manner by normalizing task-positive DLPFC dysfunction in ASD boys and enhancing task-negative default mode network (DMN) deactivation in ADHD.

scholarly journals Neuropsychological differences between attention deficit hyperactivity disorder and control children and adolescents referred for academic impairment

2009 ◽  
Vol 31 (2) ◽  
pp. 141-144 ◽  
Author(s):  
Gabriel Coutinho ◽  
Paulo Mattos ◽  
Leandro F. Malloy-Diniz
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Working Memory ◽  
Children And Adolescents ◽  
Sustained Attention ◽  
Attention Deficit ◽  
Digit Span ◽  
Control Group ◽  
Memory Tests ◽  
Hyperactivity Disorder ◽  
Academic Impairment

OBJECTIVE: To compare the performances of children and adolescents with attention deficit hyperactivity disorder with a group of control comparison subjects, both taken from a large clinical sample, using some of the most widely employed attention-based Brazilian tests. METHOD: The performances of 186 children and adolescents with attention deficit hyperactivity disorder were compared to that of 80 control individuals based on attention and working memory scores. Both groups had been referred due to academic impairment. All individuals were submitted to the TAVIS-3 sustained, shifted and focused attention tests, as well as to the working memory tests that make up the WISC-III Freedom from Distractibility Index (Digit Span and Arithmetic). RESULTS: The control group was slightly older than the attention deficit hyperactivity disorder group (p = 0.07); IQ and schooling did not differ between groups (p = 0.34 and p = 0.38, respectively). While performing a test requiring sustained attention for a longer period of time, the attention deficit hyperactivity disorder group showed a significantly higher number of commission errors compared to the controls, thus presenting sustained attention deficits (p = 0.003); when the influence of IQ, age and schooling was reduced, the attention deficit hyperactivity disorder group also made more omission errors during a sustained attention task in comparison to the control group, thus achieving a borderline significance level (p = 0.08); the attention deficit hyperactivity disorder group also performed worse in Digit Span forward and backward (p = 0.013 and p = 0.01, respectively) and in Arithmetic (p = 0.008). Other scores did not achieve significance. CONCLUSION : Our findings suggest that some of the most commonly used Brazilian attention-based tests - especially the sustained attention and working memory tests - may be useful to help distinguish subjects with attention deficit hyperactivity disorder from control subjects.

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