A cognitive test to identify response to methylphenidate treatment in children with attention deficit/hyperactivity disorder

آزمون شناختی در ADHD

Journal of Attention Disorders / 2014 Aug 13

Cognitive Testing to Identify Children With ADHD Who Do and Do Not Respond to Methylphenidate

Glen R. Elliott, Christine Blasey, William Rekshan, A. John Rush, Donna M. Palmer, Simon Clarke, Michael Kohn, Craig Kaplan, and Evian Gordo

DOI: 10.1177/1087054714543924

Objective: To investigate the effect of cognitive measurements in predicting the response to methylphenidate (Ritalin) in children and adolescents.

Method: Participants in the iSPOT-A project completed a cognitive test before receiving 6 weeks of methylphenidate. The response criterion is a 25% decrease in ADHD IV rating scale scores. The characteristics of the received ROC operator with maximum accuracy and sensitivity have distinguished respondents from non-respondents.

Result: Overall, 62% of participants responded to methylphenidate. The response rates for the clean ROC groups ranged from 18 to 85%. Non-responders showed less cognitive communication in attention shifting, sustained attention, planning and impulsivity. A group of respondents were over ten years old and had problems with changing attention and impulsivity. The second group had improved attention shift, normal or higher CPT Continuous Confrontation Test scores, and above-average scores on the Digit Vocabulary Test.

Conclusion: Cognitive tests can provide a simple and low-cost way to plan the treatment process of children and adolescents with attention deficit/hyperactivity disorder.

Abstract

OBJECTIVE: To explore the utility of cognitive measures for predicting response of children and adolescents to methylphenidate (MPH).

METHOD: Participants from the International Study to Predict Optimized Treatment-in ADHD (iSPOT-A) completed a cognitive test battery prior to receiving 6 weeks of MPH. The responder criterion was a 25% reduction in ADHD-Rating Scale-IV scores. Receiver Operator Characteristics (ROC) classified non-responders from responders with maximal sensitivity and specificity.

RESULTS: Overall, 62% of participants responded to MPH. Response rates for ROC-identified groups ranged from 18% to 85%. Non-responders showed compromised cognition related to switching of attention, sustained attention, planning, and impulsivity. One group of responders were 10 years of age or older and had impaired switching of attention and impulsivity; a second group had enhanced switching of attention, normal or higher Continuous Performance Task (CPT) scores, and above average scores on digit span.

CONCLUSION: Cognitive tests may provide a simple, low-cost tool for treatment planning for children and adolescents with ADHD.

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