Computer-based inhibitory control training in children with Attention-Deficit/Hyperactivity Disorder (ADHD): Evidence for behavioral and neural impact

Kristin N Meyer, Rosario Santillana, Brian Miller, Wes Clapp, Marcus Way, Katrina Bridgman-Goines, Margaret A Sheridan, Kristin N Meyer, Rosario Santillana, Brian Miller, Wes Clapp, Marcus Way, Katrina Bridgman-Goines, Margaret A Sheridan

Abstract

Attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychological disorder of childhood. Medication and cognitive behavioral therapy are effective treatments for many children; however, adherence to medication and therapy regimens is low. Thus, identifying effective adjunct treatments is imperative. Previous studies exploring computerized training programs as supplementary treatments have targeted working memory or attention. However, many lines of research suggest inhibitory control (IC) plays a central role in ADHD pathophysiology, which makes IC a potential intervention target. In this randomized control trial (NCT03363568), we target IC using a modified stop-signal task (SST) training designed by NeuroScouting, LLC in 40 children with ADHD, aged 8 to 11 years. Children were randomly assigned to adaptive treatment (n = 20) or non-adaptive control (n = 20) with identical stimuli and task goals. Children trained at home for at least 5 days a week (about 15m/day) for 4-weeks. Relative to the control group, the treatment group showed decreased relative theta power in resting EEG and trending improvements in parent ratings of attention (i.e. decreases in inattentive behaviors). Both groups showed improved SST performance. There was not evidence for treatment effects on hyperactivity or teacher ratings of symptoms. Results suggest training IC alone has potential to positively impact symptoms of ADHD and provide evidence for neural underpinnings of this impact (change in theta power; change in N200 latency). This shows promising initial results for the use of computerized training of IC in children with ADHD as a potential adjunct treatment option for children with ADHD.

Conflict of interest statement

The authors have read the journal's policy and have the following competing interests: BM and WC own Neuroscouting, LLC. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.

Figures

Fig 1. CONSORT Participant flow diagram.
Fig 1. CONSORT Participant flow diagram.
Fig 2. EEG electrode map.
Fig 2. EEG electrode map.
Regions of interest were bilateral parietal (solid blue) and bilateral frontal electrodes (solid purple). Electrodes were selected using the international 10–10 system.
Fig 3
Fig 3
Training program games created by NeuroScouting, LLC: (a) Baseball game. (b) Feed the fish game. (c) Catapult game.
Fig 4
Fig 4
A. Parent ratings of inattention and hyperactivity as measured by the SNAP-IV. B. Parent ratings of inattention and hyperactivity as measured by the Conners. C. Teacher ratings of inattention and hyperactivity as measured by the Conners. D. Parent ratings of inattention and hyperactivity after being averaged and normed within this sample. Error bars represent within-subjects 95% confidence intervals [71].
Fig 5
Fig 5
Pre-training to post-training change in eyes open and eyes closed resting state theta relative power over (A) left parietal electrodes and (B) right parietal electrodes. Error bars represent within-subjects 95% confidence intervals [71].

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