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专注于执行功能的数字疗法作为注意缺陷多动障碍临床症状辅助治疗的潜在有效性:一项可行性研究

Potential effectiveness of digital therapeutics specialized in executive functions as adjunctive treatment for clinical symptoms of attention-deficit/hyperactivity disorder: a feasibility study.

作者信息

Sun Tai Hui, Yeom Ji Won, Choi Kwang-Yeon, Kim Jeong-Lan, Lee Heon-Jeong, Kim Hyun-Jin, Cho Chul-Hyun

机构信息

Department of Psychiatry, Korea University Anam Hospital, Seoul, Republic of Korea.

Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea.

出版信息

Front Psychiatry. 2023 Jul 20;14:1169030. doi: 10.3389/fpsyt.2023.1169030. eCollection 2023.

Abstract

INTRODUCTION

The role of digital therapeutics (DTx) in the effective management of attention deficit/hyperactivity disorder (ADHD) is beginning to gain clinical attention. Therefore, it is essential to verify their potential efficacy.

METHOD

We aimed to investigate the improvement in the clinical symptoms of ADHD by using DTx AimDT01 (NUROW) (AIMMED Co., Ltd., Seoul, Korea) specialized in executive functions. NUROW, which consists of Go/No-go Task- and N-Back/Updating-based training modules and a personalized adaptive algorithm system that adjusts the difficulty level according to the user's performance, was implemented on 30 Korean children with ADHD aged 6 to 12 years. The children were instructed to use the DTx for 15 min daily for 4 weeks. The Comprehensive attention test (CAT) and Childhood Behavior Checklist (CBCL) were used to assess the children at baseline and endpoint. In contrast, the ADHD-Rating Scale (ARS) and PsyToolkit were used weekly and followed up at 1 month, for any sustained effect. Repeated measures ANOVA was used to identify differences between the participants during visits, while t-tests and Wilcoxon signed-rank tests were used to identify changes before and after the DTx.

RESULTS

We included 27 participants with ADHD in this analysis. The ARS inattention ( = 4.080, = 0.010), hyperactivity ( = 5.998. < 0.001), and sum ( = 5.902, < 0.001) significantly improved. After applying NUROW, internalized ( = -3.557, = 0.001, 95% CI = -3.682--0.985), other ( = -3.434, = 0.001, effect size = -0.661), and sum scores ( = -3.081, = 0.005, 95% CI = -10.126--2.022) were significantly changed in the CBCL. The overall effect was confirmed in the ARS sustained effect analysis even after 1 month of discontinuing the DTx intervention.

DISCUSSION

According to caregivers, the findings indicate that DTx holds potential effect as an adjunctive treatment in children with ADHD, especially in subjective clinical symptoms. Future studies will require detailed development and application targeting specific clinical domains using DTx with sufficient sample sizes.: KCT0007579.

摘要

引言

数字疗法(DTx)在注意缺陷多动障碍(ADHD)有效管理中的作用开始受到临床关注。因此,验证其潜在疗效至关重要。

方法

我们旨在通过使用专门针对执行功能的DTx AimDT01(NUROW,韩国首尔AIMMED有限公司)来研究ADHD临床症状的改善情况。NUROW由基于Go/No-go任务和N-Back/更新的训练模块以及根据用户表现调整难度水平的个性化自适应算法系统组成,对30名6至12岁的韩国ADHD儿童实施。指导这些儿童每天使用DTx 15分钟,持续4周。在基线和终点使用综合注意力测试(CAT)和儿童行为检查表(CBCL)对儿童进行评估。相比之下,每周使用ADHD评定量表(ARS)和PsyToolkit,并在1个月时进行随访,以观察是否有持续效果。重复测量方差分析用于确定访视期间参与者之间的差异,而t检验和Wilcoxon符号秩检验用于确定DTx前后的变化。

结果

本分析纳入了27名ADHD参与者。ARS注意力不集中( = 4.080, = 0.010)、多动( = 5.998, < 0.001)和总分( = 5.902, < 0.001)显著改善。应用NUROW后,CBCL中的内化问题( = -3.557, = 0.001,95%CI = -3.682--0.985)、其他问题( = -3.434, = 0.001,效应大小 = -0.661)和总分( = -3.081, = 0.005,95%CI = -10.126--2.022)有显著变化。即使在停止DTx干预1个月后,ARS持续效果分析中仍证实了总体效果。

讨论

根据照料者的说法, 研究结果表明DTx作为ADHD儿童的辅助治疗具有潜在效果,尤其是在主观临床症状方面。未来的研究需要使用足够样本量的DTx针对特定临床领域进行详细的开发和应用。试验注册号:KCT0007579。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78b9/10397734/fd09b303c525/fpsyt-14-1169030-g001.jpg

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