The effects of cognitive remediation on ADHD symptoms

Institution: University of Lausanne

Investigator(s): Michel Bader

Program: Cogmed RM/QM

Background & Aim: Neuroimaging studies have begun to document both structural and functional pathological changes in fronto-subcortical-cerebellar circuits in ADHD patients, but the utility of the findings are limited for purposes of diagnosis. However, it is possible that a better and more precise knowledge about the pathophysiology of ADHD and its relationship to therapeutic intervention will lead to improved diagnostic and treatment strategies. Thus, the intent of this ongoing Cogmed training study is to: a) better understand the anatomical substrates of working memory (WM) and executive function (EF) deficits in patients suffering from ADHD and b) delineate the effects of cognitive remediation (ie., Cogmed RM and Cogmed QM) on ADHD symptoms.
To investigate whether and to what extend Cogmed improved ADHD symptoms, researchers are currently conducting a randomized, double-blinded, study comparing 30 adolescents and 30 adults with ADHD who undergo adaptive-training compared to an age, sex, and socioeconomic status matched control group. In order to evaluate the efficacy of Cogmed, researchers will look at changes in inattention and hyperactivity subscale scores on the ADHD-RS scale for adolescents, the Conner’s Adult ADHD-RS scale for adults and the Clinical Global Scale Impression Scale for both groups. The impact of Cogmed on cerebral brain activity will also be examined using fMRI, so to quantify performance of EFs before and after Cogmed and to delineate the impact of Cogmed on brain function. Researchers will further compare the specific characteristics of individuals who respond positively to Cogmed with those who are less responsive to the intervention; assessing whether individuals who improve the most in EF (including WM) have different DSM-IV classifications. The intended analysis will hopefully reveal whether positive responders to Cogmed have different outcomes in terms of school and family adaption.

Population & Sample Size: N = 120 adolescents/adults, with and without ADHD, ages 13 – 18 years and 19-50 years

Design: Randomized, double-blinded, passive controlled, test-retest, fMRI