Effects of computerized cognitive training as add-on treatment to stimulants in ADHD: a pilot fMRI study
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ORIGINAL RESEARCH
Effects of computerized cognitive training as add-on treatment to stimulants in ADHD: a pilot fMRI study Virginia de Oliveira Rosa 1,2 & Alexandre Rosa Franco 3,4 & Giovanni Abrahão Salum Júnior 2,5 & Carlos Renato Moreira-Maia 2 & Flávia Wagner 2 & André Simioni 1,2 & Caroline de Fraga Bassotto 2 & Guilherme R. Moritz 2 & Cristiano Schaffer Aguzzoli 6 & Augusto Buchweitz 7 & Marcelo Schmitz 2 & Katya Rubia 8 & Luis Augusto Paim Rohde 2,5
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract The neurofunctional effects of Cognitive training (CT) are poorly understood. Our main objective was to assess fMRI brain activation patterns in children with ADHD who received CT as an add-on treatment to stimulant medication. We included twenty children with ADHD from a clinical trial of stimulant medication and CT (10 in medication + CT and 10 in medication + non-active training). Between-group differences were assessed in performance and in brain activation during 3 fMRI paradigms of working memory (N-back: 0-back, 1-back, 2-back, 3-back), sustained attention (Sustained Attention Task - SAT: 2 s, 5 s and 8 s delays) and inhibitory control (Go/No-Go). We found significant group x time x condition interactions in working memory (WM) and sustained attention on brain activation. In N-back, decreases were observed in the BOLD signal change from baseline to endpoint with increasing WM load in the right insula, right putamen, left thalamus and left pallidum in the CT compared to the non-active group; in SAT - increases in the BOLD signal change from baseline to endpoint with increasing delays were observed in bilateral precuneus, right insula, bilateral associative visual cortex and angular gyrus, right middle temporal, precentral, postcentral, superior frontal and middle frontal gyri in the CT compared to the non-active group. CT in ADHD was associated with changes in activation in task-relevant parietal and striato-limbic regions of sustained attention and working memory. Changes in brain activity may precede behavioral performance modifications in working memory and sustained attention, but not in inhibitory control. Keywords ADHD . Methylphenidate . Cognitive training . fMRI . Neuroimage
Introduction Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders of childhood and adolescence (Buitelaar and Medori 2010) with an estimated prevalence of around 5%
* Virginia de Oliveira Rosa [email protected] 1
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Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS CEP: 90035-903, Brazil Center for Biomedical Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
(Polanczyk et al. 2007). It is chara
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