Background
Attention-deficit/hyperactivity disorder (ADHD) is associated with a broad range of
neuropsychological impairments. The relationship between these neuropsychological
deficits and the defining symptoms of ADHD seems more complex than originally thought.
Methylphenidate (MPH) is an effective treatment for ADHD symptoms, but its impact
on cognition is less clearly understood.
Methods
With a common systematic search strategy and a rigorous coding and data extraction
strategy across domains, we searched electronic databases to identify published placebo
controlled trials that compared MPH and placebo on executive and nonexecutive memory,
reaction time, reaction time variability and response inhibition in children and adolescents
(5–18 years) with a formal diagnosis of ADHD.
Results
Sixty studies were included in the review, of which 36 contained sufficient data for
meta-analysis. Methylphenidate was superior to placebo in all five meta-analyses:
executive memory, standardized mean difference (SMD) .26, 95% confidence interval
(CI): −.39 to −.13; non-executive memory, SMD .60, 95% CI: −.79 to −.41; reaction
time, SMD .24, 95% CI: −.33 to −.15; reaction time variability, SMD .62, 95% CI: −.90
to −.34; response inhibition, SMD .41, 95% CI: −.55 to −.27.
Conclusions
These data support the potentially important effects of MPH on various aspects of
cognition known to be associated with ADHD. Consideration should be given to adding
cognitive outcomes to the assessment of treatment outcome in ADHD, considering the
complexity of the relationship between ADHD symptoms and cognition.
Key Words
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Article info
Publication history
Published online: November 14, 2013
Accepted:
October 3,
2013
Received in revised form:
October 3,
2013
Received:
July 14,
2013
Identification
Copyright
© 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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- The Impact of Stimulants on Cognition and the Brain in Attention-Deficit/Hyperactivity Disorder: What Does Age Have to Do With It?Biological PsychiatryVol. 76Issue 8
- PreviewOver the past several decades, a body of research has emerged on how cognitive competencies and their underlying neurobiological substrates change with development. This research exemplifies a dimensional approach of how cognitive abilities gradually evolve from simple to complex, how they vary across individuals, and how such variation contributes to risk for or resilience from mental disorders. Using dimensional measures to capture developmental and individual variation in cognition rather than relying on categorical or diagnostic measures may enhance our ability to delineate brain-behavior associations and link them more directly to core elements of psychopathology (1).
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