Comparing the Transfer Effects of Three Neurocognitive Training Protocols in Children With Attention-Deficit/Hyperactivity Disorder: A Single-Case Experimental Design

Effectiveness of cognitive rehabilitation in children and adolescents with ADHD: A review of EEG studies

BACKGROUND

Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by behavioral, cognitive, and neural differences that can significantly impact individuals in multiple areas of their lives. For a therapeutic intervention to be considered successful, it should not only address the targeted areas but also address other challenges faced by individuals with ADHD. This comprehensive approach can help reduce both the cost and duration of treatment. Thus, the objective of this mini review is to examine the transferability of cognitive rehabilitation methods that focus on working memory and/or inhibitory control on resting-state electroencephalography (EEG) findings.

METHOD

A systematic search was performed in PubMed, Web of Science, and Scopus to identify relevant studies published before 30th of July 2024. A total of 7 studies were included in our data extraction process.

RESULTS

Cognitive rehabilitation methods targeting working memory and/or inhibitory control generally assisted in change EEG frequencies in children and adolescents with ADHD. However, its efficiency was different in diverse brain frequency bands.

LIMITATIONS

The analysis of the available literature was restricted due to the small number of studies with non-homogeneous characteristics - both in terms of methodology and clinical aspects - which restricted our ability to draw comprehensive conclusions.

CONCLUSION

Notably, there was a consistent decrease in theta power observed among participants with ADHD when contrasted with an age- and gender-matched control group. However, there was no significant effect on beta power. Further research is necessary to comprehensively evaluate the effectiveness of these interventions across alpha and delta frequencies.

A systematic review of interventions for neurocognitive dysfunctions in patients and survivors of a pediatric brain tumor

Due to a high burden of neurocognitive impairment on patients with a pediatric brain tumor, interventions mitigating these symptoms are highly needed. Currently, evidence on the efficacy and feasibility of such interventions remains scarce. A systematic literature study was performed based on four different databases (PubMed, Web of Science Core Collection, Embase, and PsycArticles). Resulting articles (n = 2232) were screened based on title and abstract, and full text. We included 28 articles, investigating cognitive effects of either a lifestyle intervention (n = 6), a cognitive training (n = 15), or pharmacological intervention (n = 7). The most frequently studied interventions were the Cogmed and methylphenidate. Most interventions showed short-term efficacy. Fewer interventions also showed long-term maintenance of positive results. Despite positive trends of these interventions, results are heterogeneous, suggesting relatively limited efficacy of existing interventions and more potential of more individualized as well as multimodal approaches for future interventions.

Perspectives on heterogeneity-informed cognitive training for attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (AD/HD) is a heterogeneous neurodevelopmental condition, posing a severe threat to quality of life. Pharmacological therapies are the front-line treatment; however, their shortages encourage the development of alternative treatments for AD/HD. One promising method of developing alternative treatments is cognitive training (CT). A CT-based therapy was recently approved by the US Food and Drug Administration. However, due to heterogeneity in AD/HD, a CT protocol is unlikely to provide a one-size-fits-all solution for all patients with AD/HD. Therefore, this article highlights key aspects that need to be considered to further develop CT protocols for AD/HD, regarding training content, timing, suitability, and delivery mode. The perspectives presented here contribute to optimizing CT as an alternative option for treating AD/HD.

A randomized controlled study of remote computerized cognitive, neurofeedback, and combined training in the treatment of children with attention-deficit/hyperactivity disorder

There is an increasing interest in non-pharmacological treatments for children with attention-deficit/hyperactivity disorder (AD/HD), especially digital techniques that can be remotely delivered, such as neurofeedback (NFT) and computerized cognitive training (CCT). In this study, a randomized controlled design was used to compare training outcomes between remotely delivered NFT, CCT, and combined NFT/CCT training approaches. A total of 121 children with AD/HD were randomly assigned to the NFT, CCT, or NFT/CCT training groups, with 80 children completing the training program. Pre- and post-training symptoms (primary outcome), executive and daily functions were measured using questionnaires as well as resting EEG during eyes-closed (EC) and eyes-open (EO) conditions. After 3 months of training, the inattentive and hyperactive/impulsive symptoms, inhibition, working memory, learning and life skills of the three groups of children were significantly improved. The objective EEG activity showed a consistent increase in the relative alpha power in the EO condition among the three training groups. Training differences were not observed between groups. There was a positive correlation between pre-training EO relative alpha power and symptom improvement scores of inattention and hyperactivity/impulsivity, as well as a negative correlation between pre-training inattention scores and change in EO relative alpha. This study verified the training effects of NFT, CCT, and combined NFT/CCT training in children with AD/HD and revealed an objective therapeutic role for individual relative alpha activity. The verified feasibility and effectiveness of home-based digital training support promotion and application of digital remote training.