Can Neurocognitive Outcomes Assist Measurement-Based Care for Children with Attention-Deficit/Hyperactivity Disorder? A Systematic Review and Meta-Analyses of the Relationships Among the Changes in Neurocognitive Functions and Clinical Outcomes of Attention-Deficit/Hyperactivity Disorder in Pharmacological and Cognitive Training Interventions

Assessing therapeutic response to methylphenidate among children and adolescents with Attention-Deficit Hyperactivity Disorder: Narrative Review of its effects on emotional regulation, executive functions, and quality of life

“…c h i l d r e n a n d a d o l e s c e n t s w i t h A D H D Methylphenidate's effects have shown to be significant in terms of symptom reduction (e.g., Correll et al, 2021; Large effect size) and ER improvement by reducing overt and covert dysregulated behaviors (e.g., Pringshein et al, 2015; moderate to large effect sizes). When examining methylphenidate's effects on EFs as a unitary construct, they range from low to medium (e.g., Correll et al, 2021): Methylphenidate's effects on working memory updating producing a low effect size (e.g., , its effects on inhibitory control range from low to moderate with the majority producing a low effect size (e.g., Lee et al, 2022), and its effects on cognitive flexibility have been evaluated to be significant with a moderate effect size (e.g., Vertessen et al, 2021). Finally, methylphenidate's effects on QoL are significant with a marked improvement in QoL measures (Moderate to large effect sizes, e.g., Correll et al, 2021;Storebø et al, 2015;Tsujii et al, 2020).…”

“…Secondly, the impact of methylphenidate in children and adolescents with ADHD is rather modest on EFs when compared to core ADHD symptoms, ER and QoL (see above) despite it being considered "a first-line medication" for ADHD across the lifespan, whether in short or long-acting formulations, with a switch to a different medication being recommended only all options with it have been exhausted (Drechsler et al, 2020). This suggests it might not be the best intervention for such deficits and/or it might require an adjunct treatment to maximize its therapeutic effect (e.g., Correll et al, 2021;Lee et al, 2022;Muris et al, 2018). Though, this may also stem from heterogeneity in both neurocognitive profiles and measurement of EF.…”

“…Recently, methylphenidate's effects on EFs in children and adolescents with ADHD have been evaluated in five systematic and meta-analytic reviews Lee et al, 2022;Mckenzie et al, 2022;Tamminga et al, 2016;Vertessen et al, 2021). These reviews included studies that in their vast majority, were double blind placebo controlled randomized trials with participants between the ages of 5 and 18 that examined, among other cognitive functions, working memory updating, inhibitory control, and cognitive flexibility.…”

“…All in all, the studies that evaluated inhibitory control in children and adolescents with ADHD have shown that methylphenidate improves inhibitory functions with effect sizes ranging from low (SMD = 0.29) to moderate (SMD = 0.41). For example, in a recent systematic review and meta-analysis that evaluated 19 randomized controlled trials which examined the relationship between pharmacological interventions that primarily focused on methylphenidate (16 studies) and neurocognitive functions in children and adolescents with ADHD, Lee et al (2022), observed that among the studies which evaluated inhibitory control (15 studies, n = 782) the administration of methylphenidate improved it, albeit, just like in working memory updating, to a modest degree with a low effect size (SMD = 0.29, p<0.05).…”