Wu Yingying, Xu Lingzi, Wu Zhaomin, Cao Xiaolan, Xue Gui, Wang Yufeng, Yang Binrang
Shenzhen Children's Hospital, No.7019, Yitian Rd, Shenzhen, 518000, Futian District, China.
State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China.
Child Adolesc Psychiatry Ment Health. 2023 Jan 16;17(1):9. doi: 10.1186/s13034-022-00553-z.
ADHD is associated with deficits in executive functions. Cognitive training is a promising nonpharmacological intervention for ADHD, however, there is insufficient evidence to guide the selection of training for individuals with ADHD. This pilot study aims to investigate the efficacy of executive function training targeting key executive dysfunctions in ADHD, compared with general executive function training which targets other executive functions.
A total of 127 subjects (6-12 years) diagnosed with ADHD were allocated to receive one of two different cognitive trainings. ADHD symptoms and cognitive functions were evaluated using parent-rated scales and CANTAB cognitive assessments. All participants were required to complete 48 training sessions within a two-month period.
94 out of 127 children completed the required training and assessments. Both ADHD executive function training group and general executive function training group showed significant improvement in ADHD symptoms on the ADHD Rating Scale and in executive function on the assessment of CANTAB. There was no significant difference in improvements between the two groups. Subgroup analysis suggested that children who had ADHD-RS total scores less than or equal to 28 at baseline showed greater improvement following ADHD executive function training.
This study indicates that cognitive training can improve ADHD symptoms and executive function, with no difference in efficacy between targeted and generalized cognitive training. In addition, individuals with lower symptom severity may benefit more from training targeting key ADHD executive dysfunctions.
注意力缺陷多动障碍（ADHD）与执行功能缺陷有关。认知训练是一种有前景的ADHD非药物干预方法，然而，目前尚无足够证据指导为ADHD患者选择训练方式。这项初步研究旨在调查针对ADHD关键执行功能障碍的执行功能训练的疗效，并与针对其他执行功能的一般执行功能训练进行比较。
总共127名被诊断为ADHD的6至12岁受试者被分配接受两种不同认知训练中的一种。使用家长评定量表和剑桥神经心理测试自动化成套系统（CANTAB）认知评估来评估ADHD症状和认知功能。所有参与者都被要求在两个月内完成48次训练课程。
127名儿童中有94名完成了所需的训练和评估。ADHD执行功能训练组和一般执行功能训练组在ADHD评定量表上的ADHD症状以及在CANTAB评估中的执行功能方面均有显著改善。两组之间的改善没有显著差异。亚组分析表明，基线时ADHD评定量表总分小于或等于28的儿童在接受ADHD执行功能训练后改善更大。
本研究表明，认知训练可以改善ADHD症状和执行功能，针对性认知训练和一般性认知训练在疗效上没有差异。此外，症状严重程度较低的个体可能从针对ADHD关键执行功能障碍的训练中获益更多。
