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Hamada T, Seki M, Nango E, Shibata T, Imai S, Miyata T. Enhancing effects of exercise and neurofeedback: A systematic review and meta-analysis of computer game-based interventions for pediatric ADHD. Psychiatry Res 2025; 348:116447. [PMID: 40153883 DOI: 10.1016/j.psychres.2025.116447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Revised: 03/13/2025] [Accepted: 03/13/2025] [Indexed: 04/01/2025]
Abstract
OBJECTIVE While numerous reviews examine digital interventions, including computer game-based, evidence regarding their effectiveness for ADHD symptoms remains mixed. Focusing on computer game-based interventions, this study aims to identify specific intervention features and trial-related factors that influence outcomes in pediatric ADHD symptoms through a systematic review and meta-analysis of randomized controlled trials. METHODS Comprehensive literature searches were conducted in Web of Science, PubMed and PsycINFO. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS Seventeen studies were included. Beyond common game characteristics, some interventions incorporated additional elements-such as neurofeedback, physical exercise via virtual reality (VR) and social components-allowing subgroup analyses. The neurofeedback subgroup showed the largest effect size (standardized mean difference (SMD)=-0.51, 95 % confidence interval (CI) [-0.88, -0.15], heterogeneity index (I2)=45.85 %, p < 0.05, very low certainty of evidence), followed by the physical exercise/VR subgroup (SMD=-0.40, 95 %CI [-0.76, -0.04], I2=0.00 %, p < 0.05, very low certainty of evidence). Other subgroups, including those with social components or without additional elements, did not show significant effect sizes. The physical exercise/VR subgroup demonstrated small-to-medium effect sizes in both inattention and hyperactivity/impulsivity subscales, whereas the neurofeedback subgroup showed similar effects only in inattention. Trial-level factors, including participant demographics and intervention duration, showed no significant relationship with SMD in meta-regression. CONCLUSION Although inconclusive, synergizing with game dynamics, neurofeedback and physical exercise/VR may enhance effectiveness of computer game-based interventions in addressing pediatric ADHD symptoms. Particularly, interventions with physical exercise/VR have potential to address both inattention and hyperactivity/impulsivity.
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Affiliation(s)
- Takehiko Hamada
- Waseda University, Waseda Research Institute for Science and Engineering, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan.
| | - Masaki Seki
- Okute Hospital, 121 Okutecho, Mizunami, Gifu 509-6471, Japan; Dokkyo Medical University Graduate School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
| | - Eishu Nango
- Seibo International Catholic Hospital, Department of Family Medicine, 2-5-1 Nakaochiai, Shinjuku-ku, Tokyo 161-8521, Japan; Cochrane Japan, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan; Waseda University Graduate School of Advanced Science and Engineering, Center for Advanced Biomedical Sciences, 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8480, Japan
| | - Taro Shibata
- National Cancer Center, Biostatistics Division, Center for Research Administration and Support, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Shinya Imai
- Waseda University Graduate School of Advanced Science and Engineering, Center for Advanced Biomedical Sciences, 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8480, Japan
| | - Toshio Miyata
- Waseda University Graduate School of Advanced Science and Engineering, Center for Advanced Biomedical Sciences, 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8480, Japan
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Zheng P, Yuan K, Liu S, Xue Z, Ma P, Teo EW, Chang J. Effects of virtual reality technology on attention deficit in children with ADHD: A systematic review and Meta-analysis. J Affect Disord 2025; 384:127-134. [PMID: 40345442 DOI: 10.1016/j.jad.2025.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2025] [Revised: 05/05/2025] [Accepted: 05/06/2025] [Indexed: 05/11/2025]
Abstract
BACKGROUND Virtual reality (VR) technology is increasingly utilized in the medical field, including interventions for attention deficit hyperactivity disorder (ADHD) in children. However, evidence on the efficacy of VR-based interventions in improving attention remains limited and inconclusive. OBJECTIVE This systematic review synthesizes evidence from randomized controlled trials (RCTs) to evaluate the effectiveness of VR-based interventions in addressing attention deficits in children with ADHD and identifies key methodological insights. METHODS Six databases were searched for English-language RCTs involving children aged 6-12 years with ADHD receiving VR interventions. The Cochrane bias risk assessment tool was used to assess methodological quality. Statistical analyses included meta-analysis for effect size estimation and publication bias testing. RESULTS Eleven RCTs involving 640 participants were included. Meta-analysis revealed a moderate reduction in attention deficit symptoms (SMD = -0.33, 95%CI [-0.58, -0.09], p = 0.008). No significant publication bias was detected. CONCLUSION VR-based interventions show potential in alleviating attention deficits in children with ADHD. However, study heterogeneity and limited long-term data warrant caution. Future research should focus on large-scale, standardized trials with extended follow-ups to validate these findings.
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Affiliation(s)
- Peiyun Zheng
- School of Physical Education, Southwest University, Chongqing 400715, China; Institute of Motor Quotient, Southwest University, Chongqing 400715, China
| | - Kun Yuan
- School of Physical Education, Southwest University, Chongqing 400715, China; Institute of Motor Quotient, Southwest University, Chongqing 400715, China
| | - Shenghui Liu
- Faculty of Sports and Exercise Science, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Zhuolin Xue
- School of Physical Education, Southwest University, Chongqing 400715, China; Institute of Motor Quotient, Southwest University, Chongqing 400715, China
| | - Pengwei Ma
- School of Physical Education, Southwest University, Chongqing 400715, China; Institute of Motor Quotient, Southwest University, Chongqing 400715, China
| | - Eng Wah Teo
- Faculty of Sports and Exercise Science, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Jindong Chang
- School of Physical Education, Southwest University, Chongqing 400715, China; Faculty of Sports and Exercise Science, University of Malaya, Kuala Lumpur 50603, Malaysia; Institute of Motor Quotient, Southwest University, Chongqing 400715, China.
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Wang X, Jia Q, Liang L, Zhou W, Yang W, Mu J. Artificial intelligence in ADHD: a global perspective on research hotspots, trends and clinical applications. Front Hum Neurosci 2025; 19:1577585. [PMID: 40276113 PMCID: PMC12018397 DOI: 10.3389/fnhum.2025.1577585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2025] [Accepted: 03/31/2025] [Indexed: 04/26/2025] Open
Abstract
Background Artificial Intelligence (AI), has garnered attention in research on attention deficit hyperactivity disorder (ADHD). In the future, AI may have clinical applications in ADHD, particularly in facilitating the objective diagnosis and classification of ADHD. This study aimed to comprehensively analyze the current status and research frontiers of AI applications in ADHD, identifying hotspots and trends to guide future research directions and promote clinical advancements in this field. Methods Articles in the field of AI applications in ADHD were from the Web of Science Core Collection (WoSCC) database. Analysis was conducted using CiteSpace 6.3.R.1. Additionally, high-impact articles were analyzed. Results A total of 342 articles from 50 countries and regions were included. The United States led with 103 articles, having the highest H-index of 21, followed by China with 69 articles, and England with 34 articles. The State University of New York System produced the most articles (11), and Frontiers in Psychiatry had the most articles (12). Burst keywords in 2022-2024 included "diagnosis," "network," "attention deficit hyperactivity disorder" and "artificial intelligence." Conclusion AI technologies have become a prominent topic in ADHD research, with the United States, China, and England leading in articles and influence. The State University of New York System was the most influential institution, while Frontiers in Psychiatry stood out as the key journal. Utilizing networks and other AI technologies for diagnosing ADHD represents current hotspots and future trends, potentially offering objective indicators for ADHD.
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Affiliation(s)
- Xiaofang Wang
- Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Qianfang Jia
- Department of Children's Rehabilitation, First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
- Xinxiang Autism Integration Education Engineering and Technology Research Center, Xinxiang, China
| | - Lvyuan Liang
- School of Pediatric Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Weiwei Zhou
- Shenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, China
| | - Weihua Yang
- Shenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, China
| | - Jingfeng Mu
- Shenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, China
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Bilan DS, Chicchi Giglioli IA, Cuesta P, Cañadas E, de Ramón I, Maestú F, Alda J, Ramos-Quiroga JA, Herrera JA, Amado A, Quintero J. Decreased impulsiveness and MEG normalization after AI-digital therapy in ADHD children: a RCT. NPJ MENTAL HEALTH RESEARCH 2025; 4:1. [PMID: 39779908 PMCID: PMC11711623 DOI: 10.1038/s44184-024-00111-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 12/13/2024] [Indexed: 01/11/2025]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) presents with symptoms like impulsiveness, inattention, and hyperactivity, often affecting children's academic and social functioning. Non-pharmacological interventions, such as digital cognitive therapy, are emerging as complementary treatments for ADHD. The randomized controlled trial explored the impact of an AI-driven digital cognitive program on impulsiveness, inattentiveness, and neurophysiological markers in 41 children aged 8-12 with ADHD. Participants received either 12 weeks of AI-driven therapy or a placebo intervention. Assessments were conducted pre- and post-intervention and magnetoencephalography (MEG) analyzed brain activity. Results showed significant reductions in impulsiveness and inattentiveness scores in the treatment group, associated with normalized MEG spectral profiles, indicating neuromaturation. Notably, improvements in inhibitory control correlated with spectral profile normalization in the parieto-temporal cortex. Improvements in inhibitory control, linked to normalized spectral profiles, suggest AI-driven digital cognitive therapy can reduce impulsiveness in ADHD children by enhancing neurophysiological efficiency. This emphasizes personalized, technology-driven ADHD treatment, using neurophysiological markers for assessing efficacy.
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Affiliation(s)
- Danylyna Shpakivska Bilan
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Complutense University of Madrid, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, 28040, Madrid, Spain
| | | | - Pablo Cuesta
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, 28040, Madrid, Spain
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, Madrid, Spain
| | | | | | - Fernando Maestú
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Complutense University of Madrid, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, 28040, Madrid, Spain
| | - Jose Alda
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain
- Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalunya, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalunya, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | | | - Alfonso Amado
- Neuropediatrics Unit, University Hospital of Vigo, Vigo, Spain
| | - Javier Quintero
- Department of Psychiatry, University Hospital Infanta Leonor, 28031, Madrid, Spain
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Perry N, Sun C, Munro M, Boulton KA, Guastella AJ. AI technology to support adaptive functioning in neurodevelopmental conditions in everyday environments: a systematic review. NPJ Digit Med 2024; 7:370. [PMID: 39702672 PMCID: PMC11659516 DOI: 10.1038/s41746-024-01355-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 11/22/2024] [Indexed: 12/21/2024] Open
Abstract
Supports for adaptive functioning in individuals with neurodevelopmental conditions (NDCs) is of umost importance to long-term outcomes. Artificial intelligence (AI)-assistive technologies has enormous potential to offer efficient, cost-effective, and personalized solutions to address these challenges, particularly in everday environments. This systematic review examines the existing evidence for using AI-assistive technologies to support adaptive functioning in people with NDCs in everyday settings. Searches across six databases yielded 15 studies meeting inclusion criteria, focusing on robotics, phones/computers and virtual reality. Studies most frequently recruited children diagnosed with autism and targeted social skills (47%), daily living skills (26%), and communication (16%). Despite promising results, studies addressing broader transdiagnostic needs across different NDC populations are needed. There is also an urgent need to improve the quality of evidence-based research practices. This review concludes that AI holds enormous potential to support adaptive functioning for people with NDCs and for personalized health support. This review underscores the need for further research studies to advance AI technologies in this field.
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Affiliation(s)
- Nina Perry
- Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Carter Sun
- Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Martha Munro
- Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Kelsie A Boulton
- Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Adam J Guastella
- Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
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Liu X, Yang Y, Ye Z, Wang F, Zeng K, Sun Y, Huang Y, Dai L. The effect of digital interventions on attention deficit hyperactivity disorder (ADHD): A meta-analysis of randomized controlled trials. J Affect Disord 2024; 365:563-577. [PMID: 39191306 DOI: 10.1016/j.jad.2024.08.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 08/18/2024] [Accepted: 08/23/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity. Individuals with ADHD often encounter heightened emotional and behavioral challenges. This study aims to conduct a meta-analysis of the efficacy of digital interventions in improving symptoms of ADHD. METHODS This study searched 6 databases for English articles from database construction until December 4, 2023. Randomized controlled trials employing digital interventions for ADHD were gathered. Following the Cochrane Collaboration criteria, Review Manager 5.3 software was utilized to evaluate the risk of bias present in the included papers. Mean differences for post-intervention and follow-up data were standardized using Stata 18.0 software. Subgroup analysis was employed to investigate the sources of heterogeneity. The study adhered to the PRISMA guidelines and was registered on the PROSPERO platform (CRD42024504134). RESULTS This review included a total of 25 randomized controlled trials (RCTs). The combined study population comprised 1780 cases. In the digital intervention groups, there was a significant decrease in overall ADHD symptoms (SMD = -0.33; 95 % CI = [-0.51, -0.16]) compared to the control groups. Furthermore, there was a significant reduction in inattention symptoms (SMD = -0.31; 95 % CI = [-0.46, -0.15]) and hyperactivity/impulsivity symptoms (SMD = -0.15; 95 % CI = [-0.29, -0.02]) within the digital intervention groups. CONCLUSION The digital interventions proved beneficial for individuals with ADHD by alleviating symptoms of ADHD, inattention, and hyperactivity/impulsivity.
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Affiliation(s)
- Xin Liu
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yawen Yang
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Zhiyu Ye
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Fang Wang
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Kuan Zeng
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Ye Sun
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Ying Huang
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Lisha Dai
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China.
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Almeida-Antunes N, Antón-Toro L, Crego A, Rodrigues R, Sampaio A, López-Caneda E. Trying to forget alcohol: Brain mechanisms underlying memory suppression in young binge drinkers. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111053. [PMID: 38871018 DOI: 10.1016/j.pnpbp.2024.111053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/15/2024]
Abstract
People are able to voluntarily suppress unwanted thoughts or memories, a phenomenon known as suppression-induced forgetting or memory suppression. Despite harmful alcohol use, such as binge drinking, has been linked to impaired inhibitory control (IC) and augmented alcohol-cue reactivity, no study to date has assessed memory inhibition abilities towards alcohol-related cues in binge drinkers (BDs). Thus, the present preregistered study aimed to evaluate the behavioral and neurofunctional mechanisms associated with memory inhibition, specifically those related to the suppression of alcohol-related memories, in young BDs. For this purpose, electroencephalographic activity was recorded in eighty-two college students aged between 18 and 24 years old from the University of Minho (50% females; 40 non/low-drinkers [N/LDS] and 42 BDs) while they performed the Think/No-Think Alcohol task. Brain functional connectivity (FC) was calculated using the phase locking value and, subsequently, a dynamic seed-based analysis was conducted to explore the FC patterns between IC and memory networks. Comparatively to N/LDs, BDs exhibited decreased alpha-band FC between the anterior cingulate cortex and the left fusiform gyrus during attempts to suppress non-alcohol memories, accompanied by unsuccessful forgetting of those memories. Conversely, BDs displayed augmented gamma-band FC between the IC network and memory regions -i.e., hippocampus, parahippocampus and fusiform gyrus- during suppression of alcohol-related memories. Inhibitory abnormalities in BDs may lead to hypoconnectivity between IC and memory networks and deficient suppression of non-alcohol-related memories. However, while suppressing highly salient and reward-predicting stimuli, such as alcohol-related memories, BDs display a hyperconnectivity pattern between IC and memory networks, likely due to their augmented attention towards intrusive alcoholic memories and the attempts to compensate for potential underlying IC deficits. These findings hold important implications for alcohol research and treatment, as they open up new avenues for reducing alcohol use by shifting the focus to empowering suppression/control over alcohol-related memories. CLINICAL TRIAL REGISTRATION: [http://www.ClinicalTrials.gov], identifier [NCT05237414].
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Affiliation(s)
- Natália Almeida-Antunes
- Psychological Neuroscience Laboratory (PNL), Psychology Research Center (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Luis Antón-Toro
- Department of Experimental Psychology, Complutense University of Madrid (UCM), 28223 Madrid, Spain
| | - Alberto Crego
- Psychological Neuroscience Laboratory (PNL), Psychology Research Center (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Rui Rodrigues
- Psychological Neuroscience Laboratory (PNL), Psychology Research Center (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Adriana Sampaio
- Psychological Neuroscience Laboratory (PNL), Psychology Research Center (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Eduardo López-Caneda
- Psychological Neuroscience Laboratory (PNL), Psychology Research Center (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
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Wols A, Pingel M, Lichtwarck-Aschoff A, Granic I. Effectiveness of applied and casual games for young people's mental health: A systematic review of randomised controlled studies. Clin Psychol Rev 2024; 108:102396. [PMID: 38320420 DOI: 10.1016/j.cpr.2024.102396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
Many youth experience mental health problems and digital games hold potential as mental health interventions. This systematic review provides an overview of randomised controlled studies assessing the effectiveness of digital applied and casual games for improving mental health in youth aged 6-24 years. A systematic search of PsycINFO, Web of Science and Pubmed yielded 145 eligible studies. Studies on (sub)clinical participant samples (n = 75) most often focused on attention-deficit/hyperactivity disorder (ADHD), autism and anxiety. Applied games were found most effective for improving social skills, verbal memory and anxiety, whereas casual games were found most effective for improving depression, anxiety and ADHD. Studies involving healthy youth (n = 70) were grouped into papers examining anxiety in medical settings, momentary effects on positive and negative affect, and papers employing a longitudinal design measuring mental health trait outcomes. Promising results were found for the use of games as distraction tools in medical settings, and for applied and casual games for improving momentary affect. Overall, our findings demonstrate the potential of digital games for improving mental health. Implications and recommendations for future research are discussed, such as developing evaluation guidelines, clearly defining applied games, harmonising outcome measures, including positive outcomes, and examining nonspecific factors that may influence symptom improvement as well.
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Affiliation(s)
- Aniek Wols
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands.
| | - Michelle Pingel
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - Anna Lichtwarck-Aschoff
- Rijksuniversiteit Groningen, Department of Pedagogical & Educational Sciences, Groningen, the Netherlands
| | - Isabela Granic
- McMaster University, Health, Aging & Society, Hamilton, Ontario, Canada
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9
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Martindale APL, Llewellyn CD, de Visser RO, Ng B, Ngai V, Kale AU, di Ruffano LF, Golub RM, Collins GS, Moher D, McCradden MD, Oakden-Rayner L, Rivera SC, Calvert M, Kelly CJ, Lee CS, Yau C, Chan AW, Keane PA, Beam AL, Denniston AK, Liu X. Concordance of randomised controlled trials for artificial intelligence interventions with the CONSORT-AI reporting guidelines. Nat Commun 2024; 15:1619. [PMID: 38388497 PMCID: PMC10883966 DOI: 10.1038/s41467-024-45355-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
The Consolidated Standards of Reporting Trials extension for Artificial Intelligence interventions (CONSORT-AI) was published in September 2020. Since its publication, several randomised controlled trials (RCTs) of AI interventions have been published but their completeness and transparency of reporting is unknown. This systematic review assesses the completeness of reporting of AI RCTs following publication of CONSORT-AI and provides a comprehensive summary of RCTs published in recent years. 65 RCTs were identified, mostly conducted in China (37%) and USA (18%). Median concordance with CONSORT-AI reporting was 90% (IQR 77-94%), although only 10 RCTs explicitly reported its use. Several items were consistently under-reported, including algorithm version, accessibility of the AI intervention or code, and references to a study protocol. Only 3 of 52 included journals explicitly endorsed or mandated CONSORT-AI. Despite a generally high concordance amongst recent AI RCTs, some AI-specific considerations remain systematically poorly reported. Further encouragement of CONSORT-AI adoption by journals and funders may enable more complete adoption of the full CONSORT-AI guidelines.
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Affiliation(s)
| | - Carrie D Llewellyn
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Richard O de Visser
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Benjamin Ng
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK
- Christ Church, University of Oxford, Oxford, UK
| | - Victoria Ngai
- University College London Medical School, London, UK
| | - Aditya U Kale
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
| | | | - Robert M Golub
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Gary S Collins
- Centre for Statistics in Medicine//UK EQUATOR Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottowa, Canada
| | - Melissa D McCradden
- Department of Bioethics, The Hospital for Sick Children, Toronto, Canada
- Genetics & Genome Biology Research Program, Peter Gilgan Centre for Research & Learning, Toronto, Canada
- Division of Clinical and Public Health, Dalla Lana School of Public Health, Toronto, Canada
| | - Lauren Oakden-Rayner
- Australian Institute for Machine Learning, University of Adelaide, Adelaide, Australia
| | - Samantha Cruz Rivera
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- NIHR Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
| | | | | | - Christopher Yau
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
- Health Data Research UK, London, UK
| | - An-Wen Chan
- Department of Medicine, Women's College Hospital. University of Toronto, Toronto, Canada
| | - Pearse A Keane
- NIHR Biomedical Research Centre at Moorfields, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Andrew L Beam
- Department of Epidemiology, Harvard. T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Alastair K Denniston
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Biomedical Research Centre at Moorfields, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Xiaoxuan Liu
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.
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10
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Nashwan AJ, Gharib S, Alhadidi M, El-Ashry AM, Alamgir A, Al-Hassan M, Khedr MA, Dawood S, Abufarsakh B. Harnessing Artificial Intelligence: Strategies for Mental Health Nurses in Optimizing Psychiatric Patient Care. Issues Ment Health Nurs 2023; 44:1020-1034. [PMID: 37850937 DOI: 10.1080/01612840.2023.2263579] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
This narrative review explores the transformative impact of Artificial Intelligence (AI) on mental health nursing, particularly in enhancing psychiatric patient care. AI technologies present new strategies for early detection, risk assessment, and improving treatment adherence in mental health. They also facilitate remote patient monitoring, bridge geographical gaps, and support clinical decision-making. The evolution of virtual mental health assistants and AI-enhanced therapeutic interventions are also discussed. These technological advancements reshape the nurse-patient interactions while ensuring personalized, efficient, and high-quality care. The review also addresses AI's ethical and responsible use in mental health nursing, emphasizing patient privacy, data security, and the balance between human interaction and AI tools. As AI applications in mental health care continue to evolve, this review encourages continued innovation while advocating for responsible implementation, thereby optimally leveraging the potential of AI in mental health nursing.
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Affiliation(s)
- Abdulqadir J Nashwan
- Nursing Department, Hamad Medical Corporation, Doha, Qatar
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Suzan Gharib
- Nursing Department, Al-Khaldi Hospital, Amman, Jordan
| | - Majdi Alhadidi
- Psychiatric & Mental Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | | | | | | | | | - Shaimaa Dawood
- Faculty of Nursing, Alexandria University, Alexandria, Egypt
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11
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Farah L, Davaze-Schneider J, Martin T, Nguyen P, Borget I, Martelli N. Are current clinical studies on artificial intelligence-based medical devices comprehensive enough to support a full health technology assessment? A systematic review. Artif Intell Med 2023; 140:102547. [PMID: 37210155 DOI: 10.1016/j.artmed.2023.102547] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Artificial Intelligence-based Medical Devices (AI-based MDs) are experiencing exponential growth in healthcare. This study aimed to investigate whether current studies assessing AI contain the information required for health technology assessment (HTA) by HTA bodies. METHODS We conducted a systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology to extract articles published between 2016 and 2021 related to the assessment of AI-based MDs. Data extraction focused on study characteristics, technology, algorithms, comparators, and results. AI quality assessment and HTA scores were calculated to evaluate whether the items present in the included studies were concordant with the HTA requirements. We performed a linear regression for the HTA and AI scores with the explanatory variables of the impact factor, publication date, and medical specialty. We conducted a univariate analysis of the HTA score and a multivariate analysis of the AI score with an alpha risk of 5 %. RESULTS Of 5578 retrieved records, 56 were included. The mean AI quality assessment score was 67 %; 32 % of articles had an AI quality score ≥ 70 %, 50 % had a score between 50 % and 70 %, and 18 % had a score under 50 %. The highest quality scores were observed for the study design (82 %) and optimisation (69 %) categories, whereas the scores were lowest in the clinical practice category (23 %). The mean HTA score was 52 % for all seven domains. 100 % of the studies assessed clinical effectiveness, whereas only 9 % evaluated safety, and 20 % evaluated economic issues. There was a statistically significant relationship between the impact factor and the HTA and AI scores (both p = 0.046). DISCUSSION Clinical studies on AI-based MDs have limitations and often lack adapted, robust, and complete evidence. High-quality datasets are also required because the output data can only be trusted if the inputs are reliable. The existing assessment frameworks are not specifically designed to assess AI-based MDs. From the perspective of regulatory authorities, we suggest that these frameworks should be adapted to assess the interpretability, explainability, cybersecurity, and safety of ongoing updates. From the perspective of HTA agencies, we highlight that transparency, professional and patient acceptance, ethical issues, and organizational changes are required for the implementation of these devices. Economic assessments of AI should rely on a robust methodology (business impact or health economic models) to provide decision-makers with more reliable evidence. CONCLUSION Currently, AI studies are insufficient to cover HTA prerequisites. HTA processes also need to be adapted because they do not consider the important specificities of AI-based MDs. Specific HTA workflows and accurate assessment tools should be designed to standardise evaluations, generate reliable evidence, and create confidence.
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Affiliation(s)
- Line Farah
- Groupe de Recherche et d'accueil en Droit et Economie de la Santé (GRADES) Department, University Paris-Saclay, Orsay, France; Innovation Center for Medical Devices, Foch Hospital, 40 Rue Worth, 92150 Suresnes, France.
| | - Julie Davaze-Schneider
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Tess Martin
- Groupe de Recherche et d'accueil en Droit et Economie de la Santé (GRADES) Department, University Paris-Saclay, Orsay, France; Pharmacy Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Pierre Nguyen
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Isabelle Borget
- Groupe de Recherche et d'accueil en Droit et Economie de la Santé (GRADES) Department, University Paris-Saclay, Orsay, France; Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, 94805 Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, Équipe Labellisée Ligue Contre le Cancer, Villejuif, France
| | - Nicolas Martelli
- Groupe de Recherche et d'accueil en Droit et Economie de la Santé (GRADES) Department, University Paris-Saclay, Orsay, France; Pharmacy Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
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12
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He F, Qi Y, Zhou Y, Cao A, Yue X, Fang S, Zheng Y. Meta-analysis of the efficacy of digital therapies in children with attention-deficit hyperactivity disorder. Front Psychiatry 2023; 14:1054831. [PMID: 37260755 PMCID: PMC10228751 DOI: 10.3389/fpsyt.2023.1054831] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/26/2023] [Indexed: 06/02/2023] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that commonly occurs in childhood. The aim of this meta-analysis was to summarize the available evidence for the efficacy of digital therapeutics in children and adolescents with ADHD. Methods We searched the MEDLINE, EMBASE, Cochrane Library (Cochrane Database of Systematic Reviews), and Web of Science (science and social science citation index) databases for relevant studies and used Stata 15.0 software to carry out the meta-analysis. Results A total of 31 studies involving 2169 participants (1665 boys and 504 girls) aged 4-17 years old were included in the final analysis. The meta-analysis results showed that digital interventions improved the symptoms of inattention with an effect value of -0.20 (95% confidence interval [CI] -0.36, -0.04) and decreased the continuous performance task (CPT) reaction time (effect, -0.40, 95% CI -0.73, -0.07) in ADHD patients. The score for impulsive hyperactivity was slightly decreased (effect, -0.07, 95% CI -0.23, 0.09). Moreover, executive function was improved (effect, 0.71, 95% CI 0.37, 1.04). The capability of working memory appeared to be increased (effect, 0.48, 95% CI 0.21, 0.76) between the two groups. Visual appraisal of the sensitivity analysis suggested the absence of heterogeneity, and no obvious publication bias was detected. Discussion Based on the existing literature evidence, we conclude that digital therapy can be a promising therapeutic strategy for ADHD patients.
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Affiliation(s)
- Fan He
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yanjie Qi
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuanyue Zhou
- Department of Medical Psychology, The First Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Aihua Cao
- Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Xin Yue
- MaiDeHaiKe Technology, Beijing, China
| | - Shuanfeng Fang
- Children's Hospital Affiliated, Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Zheng
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
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13
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Liu XQ, Ji XY, Weng X, Zhang YF. Artificial intelligence ecosystem for computational psychiatry: Ideas to practice. World J Meta-Anal 2023; 11:79-91. [DOI: 10.13105/wjma.v11.i4.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/18/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
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14
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Westwood SJ, Parlatini V, Rubia K, Cortese S, Sonuga-Barke EJS. Computerized cognitive training in attention-deficit/hyperactivity disorder (ADHD): a meta-analysis of randomized controlled trials with blinded and objective outcomes. Mol Psychiatry 2023; 28:1402-1414. [PMID: 36977764 PMCID: PMC10208955 DOI: 10.1038/s41380-023-02000-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/01/2023] [Accepted: 02/10/2023] [Indexed: 03/30/2023]
Abstract
This meta-analysis investigated the effects of computerized cognitive training (CCT) on clinical, neuropsychological and academic outcomes in individuals with attention-deficit/hyperactivity disorder (ADHD). The authors searched PubMed, Ovid, and Web of Science until 19th January 2022 for parallel-arm randomized controlled trials (RCTs) using CCT in individuals with ADHD. Random-effects meta-analyses pooled standardized mean differences (SMD) between CCT and comparator arms. RCT quality was assessed with the Cochrane Risk of Bias 2.0 tool (PROSPERO: CRD42021229279). Thirty-six RCTs were meta-analysed, 17 of which evaluated working memory training (WMT). Analysis of outcomes measured immediately post-treatment and judged to be "probably blinded" (PBLIND; trial n = 14) showed no effect on ADHD total (SMD = 0.12, 95%CI[-0.01 to -0.25]) or hyperactivity/impulsivity symptoms (SMD = 0.12, 95%[-0.03 to-0.28]). These findings remained when analyses were restricted to trials (n: 5-13) with children/adolescents, low medication exposure, semi-active controls, or WMT or multiple process training. There was a small improvement in inattention symptoms (SMD = 0.17, 95%CI[0.02-0.31]), which remained when trials were restricted to semi-active controls (SMD = 0.20, 95%CI[0.04-0.37]), and doubled in size when assessed in the intervention delivery setting (n = 5, SMD = 0.40, 95%CI[0.09-0.71]), suggesting a setting-specific effect. CCT improved WM (verbal: n = 15, SMD = 0.38, 95%CI[0.24-0.53]; visual-spatial: n = 9, SMD = 0.49, 95%CI[0.31-0.67]), but not other neuropsychological (e.g., attention, inhibition) or academic outcomes (e.g., reading, arithmetic; analysed n: 5-15). Longer-term improvement (at ~6-months) in verbal WM, reading comprehension, and ratings of executive functions were observed but relevant trials were limited in number (n: 5-7). There was no evidence that multi-process training was superior to working memory training. In sum, CCT led to shorter-term improvements in WM, with some evidence that verbal WM effects persisted in the longer-term. Clinical effects were limited to small, setting specific, short-term effects on inattention symptoms.
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Affiliation(s)
- Samuel J Westwood
- Department of Psychology, Institute of Psychiatry, Psychology, Neuroscience, King's College London, London, UK
- School of Social Science, University of Westminster, London, UK
| | - Valeria Parlatini
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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15
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Previously Marzena Szkodo MOR, Micai M, Caruso A, Fulceri F, Fazio M, Scattoni ML. Technologies to support the diagnosis and/or treatment of neurodevelopmental disorders: A systematic review. Neurosci Biobehav Rev 2023; 145:105021. [PMID: 36581169 DOI: 10.1016/j.neubiorev.2022.105021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022]
Abstract
In recent years, there has been a great interest in utilizing technology in mental health research. The rapid technological development has encouraged researchers to apply technology as a part of a diagnostic process or treatment of Neurodevelopmental Disorders (NDDs). With the large number of studies being published comes an urgent need to inform clinicians and researchers about the latest advances in this field. Here, we methodically explore and summarize findings from studies published between August 2019 and February 2022. A search strategy led to the identification of 4108 records from PubMed and APA PsycInfo databases. 221 quantitative studies were included, covering a wide range of technologies used for diagnosis and/or treatment of NDDs, with the biggest focus on Autism Spectrum Disorder (ASD). The most popular technologies included machine learning, functional magnetic resonance imaging, electroencephalogram, magnetic resonance imaging, and neurofeedback. The results of the review indicate that technology-based diagnosis and intervention for NDD population is promising. However, given a high risk of bias of many studies, more high-quality research is needed.
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Affiliation(s)
| | - Martina Micai
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Angela Caruso
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Maria Fazio
- Department of Mathematics, Computer Science, Physics and Earth Sciences (MIFT), University of Messina, Viale F. Stagno d'Alcontres, 31, 98166 Messina, Italy.
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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16
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Quintero J, Rodríguez-Quiroga A, Álvarez-Mon MÁ, Mora F, Rostain AL. Addressing the Treatment and Service Needs of Young Adults with Attention Deficit Hyperactivity Disorder. Child Adolesc Psychiatr Clin N Am 2022; 31:531-551. [PMID: 35697400 DOI: 10.1016/j.chc.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The transition from adolescence to adulthood is a complex period in which multiple changes take place (education, work, independent living, and social relations). This stage is especially difficult for adolescents suffering from attention deficit hyperactivity disorder (ADHD), who have to move on from child and adolescent mental health services to adult mental health services. This review analyzes developmental and environmental risk and protective factors as well as critical variables such as executive functioning and self-monitoring that influence the course of ADHD in transitional age youth and guide the priorities for an optimal transition of care. The influence of the COVID-19 pandemic is also discussed. We reflect on the unmet needs for an optimal transition of care and propose practice and policy recommendations to achieve this goal.
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Affiliation(s)
- Javier Quintero
- Psychiatry and Mental Health Department, Hospital Universitario Infanta Leonor, Avenida de la Gran Vía del Este 80, Madrid 20830, Spain; Department of Legal Medicine & Psychiatry, Complutense University, Spain.
| | - Alberto Rodríguez-Quiroga
- Psychiatry and Mental Health Department, Hospital Universitario Infanta Leonor, Avenida de la Gran Vía del Este 80, Madrid 20830, Spain; Department of Legal Medicine & Psychiatry, Complutense University, Spain
| | - Miguel Ángel Álvarez-Mon
- Psychiatry and Mental Health Department, Hospital Universitario Infanta Leonor, Avenida de la Gran Vía del Este 80, Madrid 20830, Spain; Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, 28801 Alcala de Henares, Spain; Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Fernando Mora
- Psychiatry and Mental Health Department, Hospital Universitario Infanta Leonor, Avenida de la Gran Vía del Este 80, Madrid 20830, Spain; Department of Legal Medicine & Psychiatry, Complutense University, Spain
| | - Anthony L Rostain
- Department of Psychiatry, Cooper Medical School of Rowan University, 401 Broadway, Camden, NJ 08103, USA
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17
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Artificial Intelligence in NICU and PICU: A Need for Ecological Validity, Accountability, and Human Factors. Healthcare (Basel) 2022; 10:healthcare10050952. [PMID: 35628089 PMCID: PMC9140402 DOI: 10.3390/healthcare10050952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 02/04/2023] Open
Abstract
Pediatric patients, particularly in neonatal and pediatric intensive care units (NICUs and PICUs), are typically at an increased risk of fatal decompensation. That being said, any delay in treatment or minor errors in medication dosage can overcomplicate patient health. Under such an environment, clinicians are expected to quickly and effectively comprehend large volumes of medical information to diagnose and develop a treatment plan for any baby. The integration of Artificial Intelligence (AI) into the clinical workflow can be a potential solution to safeguard pediatric patients and augment the quality of care. However, before making AI an integral part of pediatric care, it is essential to evaluate the technology from a human factors perspective, ensuring its readiness (technology readiness level) and ecological validity. Addressing AI accountability is also critical to safeguarding clinicians and improving AI acceptance in the clinical workflow. This article summarizes the application of AI in NICU/PICU and consecutively identifies the existing flaws in AI (from clinicians’ standpoint), and proposes related recommendations, which, if addressed, can improve AIs’ readiness for a real clinical environment.
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18
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Medina R, Bouhaben J, de Ramón I, Cuesta P, Antón-Toro L, Pacios J, Quintero J, Quiroga AR, Maestú F. Alfa band power increases in posterior brain regions in attention deficit hyperactivity disorder after digital cognitive stimulation treatment. Brain Commun 2022; 4:fcac038. [PMID: 35402910 PMCID: PMC8984701 DOI: 10.1093/braincomms/fcac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/11/2021] [Accepted: 02/15/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
The changes triggered by pharmacological treatments in resting-state alpha-band (8–14 Hz) oscillations have been widely studied in attention deficit hyperactivity disorder. However, to date, there has been no evidence regarding the possible changes in cognitive stimulation treatments on these oscillations. This paper sets out to verify whether cognitive stimulation treatments based on progressive increases in cognitive load can be effective in triggering changes in alpha-band power in attention deficit hyperactivity disorder. With this objective, we compared a cognitive stimulation treatment (n = 13) to placebo treatment (n = 13) for 12 weeks (36 sessions of 15 min) in child patients (8–11 years old) with attention deficit hyperactivity disorder. Two magnetoencephalographic recordings were acquired for all the participants. In order to extract the areas with changes in alpha power between both magnetoencephalographic recordings, the differences in the power ratio (pre/post-condition) were calculated using an Analysis of Covariance test adjusted for the age variable. The results show an increase in the post-treatment power ratio in the experimental group versus the placebo group (P < 0.01) in posterior regions and the default mode network. In addition, these alpha changes were related to measures of attention, working memory and cognitive flexibility. The results seem to indicate that cognitive stimulation treatment based on progressive increases in cognitive load triggers alpha-band power changes in child attention deficit hyperactivity disorder patients in the direction of their peers without this disorder.
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Affiliation(s)
| | | | - Ignacio de Ramón
- Sincrolab, Ltd., Madrid 28033, Spain
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
| | - Pablo Cuesta
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
| | - Luis Antón-Toro
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid 28223, Spain
| | - Javier Pacios
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid 28223, Spain
| | - Javier Quintero
- Department of Psychiatry, University Hospital Infanta Leonor, Madrid 28031, Spain
| | | | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid 28223, Spain
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