Trinczer Inbar Lucia, Shalev Lilach
Attention Lab, School of Education, Tel-Aviv University, Tel Aviv 67017, Israel.
Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv 67017, Israel.
J Clin Med. 2024 Nov 28;13(23):7239. doi: 10.3390/jcm13237239.
: Attention deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterised by deficits in attention, hyperactivity, and impulsivity. Current treatments, such as stimulant medication and behavioural therapy, ameliorate symptoms but do not address the core cognitive dysfunctions. This study aimed to investigate the effects of two computerised neurocognitive training programs, attention functions training and executive functions training, in children with ADHD. : Eighty children with ADHD (ages 8-13) were randomly assigned to one of three groups: Attention functions training (AFT), targeting sustained, selective-spatial, orienting, and executive attention; executive functions training (EFT), focusing on working memory, cognitive flexibility, and problem solving; or a passive control group. Training sessions were administered in small groups twice a week for nine weeks. Participants underwent comprehensive assessments of attention (Continuous Performance Test, Conjunctive Visual Search Task), executive functions (Corsi Block-Tapping Tasks), nonverbal reasoning (Raven's Colored Progressive Matrices), parent-rated behavioural symptoms, and arithmetic performance at baseline, post-intervention, and follow-up. : The AFT group demonstrated significant improvements in sustained and selective-spatial attention, nonverbal reasoning, inattentive symptoms, and arithmetic performance, and most improvements persisted at follow-up. The EFT group showed gains in nonverbal reasoning and inattentive symptoms, although no improvements were documented in working memory or in parent ratings of executive functions. : The AFT program that addressed core attentional functions in children with ADHD produced robust cognitive and behavioural benefits, whereas the EFT program yielded behavioural benefits and a limited improvement in executive functions. Future research should explore different training protocols for broader gains in executive functions. These findings support the potential of theory-driven, structured neurocognitive training targeting basic cognitive functions as an effective small-group intervention for ADHD.
注意缺陷多动障碍(ADHD)是一种常见的神经发育障碍,其特征在于注意力、多动和冲动方面的缺陷。目前的治疗方法,如刺激性药物治疗和行为疗法,可改善症状,但无法解决核心认知功能障碍。本研究旨在调查两种计算机化神经认知训练项目,即注意力功能训练和执行功能训练,对ADHD儿童的影响。
80名ADHD儿童(8至13岁)被随机分配到三组中的一组:注意力功能训练(AFT)组,针对持续注意力、选择性空间注意力、定向注意力和执行注意力;执行功能训练(EFT)组,专注于工作记忆、认知灵活性和问题解决能力;或被动对照组。训练课程以小组形式每周进行两次,为期九周。参与者在基线、干预后和随访时接受了注意力(连续性能测试、联合视觉搜索任务)、执行功能(科西方块敲击任务)、非言语推理(瑞文彩色渐进矩阵)、家长评定的行为症状和算术成绩的综合评估。
AFT组在持续和选择性空间注意力、非言语推理、注意力不集中症状和算术成绩方面有显著改善,且大多数改善在随访时持续存在。EFT组在非言语推理和注意力不集中症状方面有改善,尽管在工作记忆或家长对执行功能的评定中没有记录到改善。
针对ADHD儿童核心注意力功能的AFT项目产生了强大的认知和行为益处,而EFT项目产生了行为益处,并在执行功能方面有有限的改善。未来的研究应探索不同的训练方案,以在执行功能方面获得更广泛的收益。这些发现支持了以理论为驱动、针对基本认知功能的结构化神经认知训练作为ADHD有效小组干预措施的潜力。