Treatment biomarkers for ADHD: Taking stock and moving forward

Abstract

The development of treatment biomarkers for psychiatric disorders has been challenging, particularly for heterogeneous neurodevelopmental conditions such as attention-deficit/hyperactivity disorder (ADHD). Promising findings are also rarely translated into clinical practice, especially with regard to treatment decisions and development of novel treatments. Despite this slow progress, the available neuroimaging, electrophysiological (EEG) and genetic literature provides a solid foundation for biomarker discovery. This article gives an updated review of promising treatment biomarkers for ADHD which may enhance personalized medicine and novel treatment development. The available literature points to promising pre-treatment profiles predicting efficacy of various pharmacological and non-pharmacological treatments for ADHD. These candidate predictive biomarkers, particularly those based on low-cost and non-invasive EEG assessments, show promise for the future stratification of patients to specific treatments. Studies with repeated biomarker assessments further show that different treatments produce distinct changes in brain profiles, which track treatment-related clinical improvements. These candidate monitoring/response biomarkers may aid future monitoring of treatment effects and point to mechanistic targets for novel treatments, such as neurotherapies. Nevertheless, existing research does not support any immediate clinical applications of treatment biomarkers for ADHD. Key barriers are the paucity of replications and external validations, the use of small and homogeneous samples of predominantly White children, and practical limitations, including the cost and technical requirements of biomarker assessments and their unknown feasibility and acceptability for people with ADHD. We conclude with a discussion of future directions and methodological changes to promote clinical translation and enhance personalized treatment decisions for diverse groups of individuals with ADHD.

Martial Arts and Cognitive Control in Children with Attention-Deficit Hyperactivity Disorder and Children Born Very Preterm: A Combined Analysis of Two Randomized Controlled Trials

“…In contrast, the canceling effect was not observed in healthy peers ( 54 ). Acute changes in components of the P3 family have been associated with the response to pharmacological treatment ( 55 , 56 ), suggesting that the lack of amplitude increases after coordinatively challenging exercise indexes a nonresponse to this type of exercise. Consequently, we assume that the complexity of judo might have prevented the elicitation of benefits for response inhibition in children with ADHD within the 12-wk intervention period, suggesting that for this population, exercise needs to be tailored to individual cognitive and motor abilities.…”

Revolucionando nuestros acercamientos al TDAH: nuevas perspectivas desde la Neuroeducación

“…Los neurotransmisores son responsables de ayudar a las personas a atender aspectos importantes de su ambiente. El medicamento apropiado estimula estos químicos que funcionan para producir neurotransmisores adicionales, lo cual aumenta la capacidad del niño para prestar atención, controlar los impulsos y reducir la hiperactividad (Michelini, Norman, Shaw & Loo, 2022;Zhao, Yang, Gong, Cao & Liu, 2022).…”

Remote neurocognitive interventions for attention-deficit/hyperactivity disorder – opportunities and challenges

“…The individual difference may also be true for other forms of neurocognitive training, for example, NFT (Arns et al, 2012;Su et al, 2021), VNS (Brá zdil et al, 2019), and tES (Chew et al, 2015). Also, it appears that both behavioral and brain measures carry unique value in predicting intervention effects (Michelini et al, 2022;Nemmi et al, 2016). Accordingly, in line with precision medicine, a comprehensive predictive model can be built by taking behavioral and brain measures to determine a person's suitability for specific remote neurocognitive interventions.…”