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Region Hovedstadens Psykiatri - en del af Københavns Universitetshospital

The attentional profile of children with ADHD: Focus on visual attention and association with symptom level

Projekt: Typer af projekterProjekt

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The aim of this study is to map the attentional profile in children with Attention-Deficit Hyperactivity Disorder (ADHD) using Bundesen’s Theory of Visual Attention and to investigate how measures of visual attention covary with symptoms of ADHD. The visual attentional profile will be obtained prior to and after a standard 12-week pharmacological treatment with methylphenidate, thus investigating attention in children with untreated ADHD as well as how this measure may covary with ADHD symptoms after pharmacological treatment.

The study is designed as a prospective 12 weeks follow-up study with 50 stimulant medication naïve children with ADHD between the ages of 7-12 years, and 50 healthy controls matched on age, sex, and parental socioeconomic status. Patients are recruited from the Center for Child and Adolescent Mental Health, Capital Region Psychiatry at Bispebjerg, Hillerød and Glostrup Hospitals. Control participants will be recruited from a randomly generated list obtained from the Danish Civil Registration System (CPR). Controls will be recruited continuously throughout the duration of the clinical trial to allow for matching of age, gender and parental socioeconomic status. Patients with a confirmed primary diagnosis of ADHD according to ICD-10 criteria, who have been recommended standard treatment with methylphenidate, will be offered to participate in the project. When the patients are enrolled in the project, the treatment will be carried out in collaboration with clinical doctors and nurses at the ADHD-outpatient clinic at Bispebjerg Hospital. After participating in the project, the future clinical control is continued as regular clinical practice by the doctors and nurses at the ADHD-outpatient clinic. It will be explained to the parents/the custody holder of all participants that they can withdraw from the project at any time after signing the informed consent, and that withdrawal from the project will not have any impact on their future treatment in the health care system.

Results (expected):
The current project aims to investigate the following hypotheses: 1) Visual attentional functions (derived from TVA-based testing) are different between medication-naïve children with ADHD and healthy controls and can provide an endophenotypic cognitive profile of medication-naïve children with ADHD. 2) Visual attentional functions (derived from TVA-based testing) will show a covariation with the level of ADHD symptoms before and after standard pharmacological treatment with methylphenidate in children with ADHD.

Discussion/impact (expected):
In recent years there has been a worldwide increase in the number of children diagnosed with ADHD and still more children are pharmacologically treated with psychostimulant medication such as methylphenidate. This trend has led to an internationally increased focus on ADHD, and on correctly diagnosing and treating the patients. Currently, the clinical diagnosis is based on a consensus about clusters of clinical symptoms beginning before the age of 12 (DSM-V. American Psychiatry Association 2013) and despite decades of research no specific cognitive profile is considered diagnostic for ADHD. The characterization of a more precise attentional profile would improve the validity of the ADHD diagnosis and pave the way for the development of both more individualized therapies and a more objective way of monitoring response to treatment.

ID: 61915243