Hai T, Duffy HA, Lemay JA, Lemay JF. Impact of stimulant medication on behaviour and executive functions in children with attention-deficit/hyperactivity disorder. World J Clin Pediatr 2022; 11(1): 48-60 [PMID: 35096546 DOI: 10.5409/wjcp.v11.i1.48]
Corresponding Author of This Article
Jean François Lemay, MD, FRCPC, Professor, Department of Paediatrics, Alberta Children's Hospital/Cumming School of Medicine, University of Calgary, 28 Oki Drive, NW, Room C4-627, Calgary, AB T3B 6A8, Canada. jf.lemay@ahs.ca
Research Domain of This Article
Pediatrics
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Jan 9, 2022; 11(1): 48-60 Published online Jan 9, 2022. doi: 10.5409/wjcp.v11.i1.48
Impact of stimulant medication on behaviour and executive functions in children with attention-deficit/hyperactivity disorder
Tasmia Hai, Hanna A Duffy, Julie Anne Lemay, Jean François Lemay
Tasmia Hai, Hanna A Duffy, Werklund School of Education, University of Calgary, Calgary, AB T2N 1N4, Canada
Julie Anne Lemay, Jean François Lemay, Department of Paediatrics, Alberta Children's Hospital/Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada
Author contributions: Hai T assisted with data collection, analyzed and interpreted the data and wrote the manuscript; Duffy HA assisted with data collection and reviewing of the manuscript; Lemay JA assisted with data collection; Lemay JF is the principal investigator of the study, designed the study and edited the manuscript; all authors approved the final version of the article.
Supported bythe Alberta Children's Hospital Foundation, Werklund School of Education, University of Calgary.
Institutional review board statement: Ethics approval for the following research has been renewed by the Conjoint Health Research Ethics Board (CHREB) at the University of Calgary. The CHREB is constituted and operates in compliance with the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2); Health Canada Food and Drug Regulations Division 5; Part C; ICH Guidance E6: Good Clinical Practice and the provisions and regulations of the Health Information Act, RSA 2000 c H-5. Ethics ID: REB15-3068_REN4.
Conflict-of-interest statement: The authors declare no competing financial interests. No conflict of interest to report.
Data sharing statement: Dataset available from the corresponding author at jf.lemay@ahs.ca.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jean François Lemay, MD, FRCPC, Professor, Department of Paediatrics, Alberta Children's Hospital/Cumming School of Medicine, University of Calgary, 28 Oki Drive, NW, Room C4-627, Calgary, AB T3B 6A8, Canada. jf.lemay@ahs.ca
Received: March 24, 2021 Peer-review started: March 24, 2021 First decision: June 17, 2021 Revised: July 8, 2021 Accepted: December 2, 2021 Article in press: December 2, 2021 Published online: January 9, 2022 Processing time: 289 Days and 5.2 Hours
Abstract
BACKGROUND
Children with attention-deficit/hyperactivity disorder (ADHD) often exhibit behaviour challenges and deficits in executive functions (EF). Psychostimulant medications [e.g., methylphenidate (MPH)] are commonly prescribed for children with ADHD and are considered effective in 70% of the cases. Furthermore, only a handful of studies have investigated the long-term impact of MPH medication on EF and behaviour.
AIM
To evaluate behaviour and EF challenges in children with ADHD who were involved in an MPH treatment trial across three-time points.
METHODS
Thirty-seven children with ADHD completed a stimulant medication trial to study the short- and long-term impact of medication. Children with ADHD completed three neuropsychological assessments [Continuous Performance Test (CPT)-II, Digit Span Backwards and Spatial Span Backwards]. Parents of children with ADHD completed behaviour rating scales [Behaviour Rating Inventory of Executive Functioning (BRIEF) and Behaviour Assessment System for Children-Second Edition (BASC-2)]. Participants were evaluated at: (1) Baseline (no medication); and (2) Best-dose (BD; following four-week MPH treatment). Additionally, 18 participants returned for a long-term naturalistic follow up (FU; up to two years following BD).
RESULTS
Repeated measure analyses of variance found significant effects of time on two subscales of BRIEF and four subscales of BASC-2. Neuropsychological assessments showed some improvement, but not on all tasks following the medication trial. These improvements did not sustain at FU, with increases in EF and behaviour challenges, and a decline in performance on the CPT-II task being observed.
CONCLUSION
Parents of children with ADHD reported improvements in EF and behaviours during the MPH trial but were not sustained at FU. Combining screening tools and neuropsychological assessments may be useful for monitoring medication responses.
Core Tip: Parents of children with attention-deficit/hyperactivity disorder reported improvements in executive function and behaviours during the methylphenidate trial, but these improvements did not sustain at the long-term follow up condition. Combining screening tools and neuropsychological assessments may be useful for monitoring psychostimulant medication responses as children enter their adolescent years.
