Computerized Cognitive Training in Attention-Deficit/Hyperactivity Disorder (ADHD): A Meta-Analysis of Randomized Controlled Trials With Blinded and Objective Outcomes
Molecular Psychiatry
Westwood, S. J., Parlatini, V., et al. (2023).
Molecular Psychiatry, 28(4), 1402-1414.
This updated systematic review and meta-analysis investigates the effects of computerized cognitive training (CCT) on clinical, neuropsychological, and academic outcomes in individuals with attention-deficit/hyperactivity disorder (ADHD). For more information about the previous version of this systematic review, please see the Notes on This Article section.
Not stated
This systematic review and meta-analysis is an update of: <br />
<ul>
<li>Cortese, S., Ferrin, M., et al. (2015). Cognitive Training for Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Clinical and Neuropsychological Outcomes from Randomized Controlled Trials. Journal of the American Academy of Child and Adolescent Psychiatry, 54(3), 164-174. <a title="https://doi.org/10.1016/j.jaac.2014.12.010" href="https://doi.org/10.1016/j.jaac.2014.12.010">https://doi.org/10.1016/j.jaac.2014.12.010</a></li>
</ul>
From database inception to January 19, 2022
Parallel-arm randomized controlled trials.
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The use of CCT showed:
<ul>
<li>no strong evidence to support its use as a stand-alone treatment for core ADHD symptoms;</li>
<li>a marginal effect on inattention (SMD= 0.17);</li>
<li>no effect for either ADHD symptoms overall or hyperactivity/impulsivity; and</li>
<li>similar effects for treatments targeting working memory in isolation (SMD= 0.8 to 0.17) as those targeting multiple cognitive domains (SMD= 0.11 to 0.12).</li>
</ul>
<p>Limitations to this review include significant risk of bias, reduced representation of adults, exclusion of studies comparing multiple interventions, and lack of investigation of the generalization and maintenance of treatment effects.</p>
CCT improved the following cognitive domains in individuals with ADHD:<br />
<ul>
<li>motor inhibition (SMD: 0.24 when compared to a semi-active control; not significant overall); </li>
<li>verbal working memory (SMD: 0.38); and</li>
<li>visuospatial working memory (SMD: 0.49).</li>
</ul>
No significant effects were noted for attention, interference inhibition (i.e., inhibiting reactions to irrelevant stimuli), non-verbal reasoning, processing speed, or set shifting. Limitations to this review include significant risk of bias, reduced representation of adults, exclusion of studies comparing multiple interventions, and lack of investigation of the generalization and maintenance of treatment effects.
In individuals with ADHD, CCT demonstrated no significant effect on reading comprehension, reading fluency, or arithmetic ability.<br /><br />Limitations to this review include significant risk of bias, reduced representation of adults, exclusion of studies comparing multiple interventions, and lack of investigation of the generalization and maintenance of treatment effects.
