Synergy between Behavioral and Pharmacologic Interventions for ADHD
In a new study appearing in Biological Psychiatry, published by Elsevier, researchers compared children with ADHD and typically developing children using a video-game task, which required them to focus their attention and to control impulsive actions. The children performed this task under three different motivational conditions, and the children with ADHD were tested both on and off their usual dose of medication. This allowed the researchers to compare the effects of both medication and motivation on the children’s response inhibition.
Dr. Madeleine Groom, corresponding author of the study and Professor Chris Hollis, principal investigator, explained their findings: “We found that brain electrical activity in children with ADHD when attending to the task and restraining impulsive responses differed from a comparison group of children without ADHD, but became more similar when they took stimulant medication. Intriguingly, rewards and penalties given to improve task performance also changed brain activity, and did so in both children with ADHD and in the control group, although these motivational effects were much smaller than those associated with medication.”
These findings suggest that stimulant medication tends to normalize brain function in children with ADHD and enables them to better maintain attention and restrain impulsive responses. Motivational incentives also seem to play a role in modulating similar neural circuits and work additively with medication to improve performance in children with ADHD.
Dr. John Krystal, Editor of Biological Psychiatry, commented that “the findings suggest that there may be important additive effects of stimulant medications and behavioral strategies for increasing motivation in ADHD. These interactive effects are important to bear in mind when optimizing the performance of children in school and other settings that require control of attention and behavior.”
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Notes to Editors:
The article is “Effects of Motivation and Medication on Electrophysiological Markers of Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder” by Madeleine J. Groom, Gaia Scerif, Peter F. Liddle, Martin J. Batty, Elizabeth B. Liddle, Katherine L. Roberts, John D. Cahill, Mario Liotti, and Chris Hollis. Groom, Batty, EB Liddle, Roberts, Cahill, and Hollis are affiliated with Developmental Psychiatry, University of Nottingham, Nottingham, United Kingdom. Scerif is affiliated with the Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom. PF Liddle is affiliated with Behavioural Sciences, Division of Psychiatry, University of Nottingham, Nottingham, United Kingdom. Liotti is affiliated with the Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada. The article appears in Biological Psychiatry, Volume 67, Issue 7 (April 1, 2010), published by Elsevier.
The authors’ disclosures of financial and conflicts of interests are available in the article.
John H. Krystal, M.D. is Chairman of the Department of Psychiatry at the Yale University School of Medicine and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available here.
Full text of the article mentioned above is available upon request. Contact Maureen Hunter at firstname.lastname@example.org to obtain a copy or to schedule an interview.
About Biological Psychiatry
This international rapid-publication journal is the official journal of the Society of Biological Psychiatry. It covers a broad range of topics in psychiatric neuroscience and therapeutics. Both basic and clinical contributions are encouraged from all disciplines and research areas relevant to the pathophysiology and treatment of major neuropsychiatric disorders. Full-length and Brief Reports of novel results, Commentaries, Case Studies of unusual significance, and Correspondence and Comments judged to be of high impact to the field are published, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Concise Reviews and Editorials that focus on topics of current research and interest are also published rapidly.
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