Effects of Methylphenidate on Cognitive Functions in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: Evidence from a Systematic Review and a Meta-Analysis

  • Coghill D
  • Seth S
  • Pedroso S
 et al. 
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Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with a broad range of neuropsychological impairments. The relationship between these neuropsychological deficits and the defining symptoms of ADHD seems more complex than originally thought. Methylphenidate (MPH) is an effective treatment for ADHD symptoms, but its impact on cognition is less clearly understood. Methods: With a common systematic search strategy and a rigorous coding and data extraction strategy across domains, we searched electronic databases to identify published placebo controlled trials that compared MPH and placebo on executive and nonexecutive memory, reaction time, reaction time variability and response inhibition in children and adolescents (5-18 years) with a formal diagnosis of ADHD. Results: Sixty studies were included in the review, of which 36 contained sufficient data for meta-analysis. Methylphenidate was superior to placebo in all five meta-analyses: executive memory, standardized mean difference (SMD) .26, 95% confidence interval (CI): -.39 to -.13; non-executive memory, SMD .60, 95% CI: -.79 to -.41; reaction time, SMD .24, 95% CI: -.33 to -.15; reaction time variability, SMD .62, 95% CI: -.90 to -.34; response inhibition, SMD .41, 95% CI: -.55 to -.27. Conclusions: These data support the potentially important effects of MPH on various aspects of cognition known to be associated with ADHD. Consideration should be given to adding cognitive outcomes to the assessment of treatment outcome in ADHD, considering the complexity of the relationship between ADHD symptoms and cognition. ?? 2013 Society of Biological Psychiatry.

Author-supplied keywords

  • ADHD
  • Age Factors
  • Attention Deficit Disorder with Hyperactivity
  • Attention Deficit Disorder with Hyperactivity: com
  • Central Nervous System Stimulants
  • Central Nervous System Stimulants: therapeutic use
  • Cognition Disorders
  • Cognition Disorders: drug therapy
  • Cognition Disorders: etiology
  • Methylphenidate
  • Methylphenidate: therapeutic use
  • Neuropsychological Tests
  • cognition
  • inhibition
  • memory
  • meta-analysis
  • methylphenidate
  • neuropsychology
  • systematic review

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  • David R Coghill

  • Sarah Seth

  • Sara Pedroso

  • Tatiana Usala

  • John Currie

  • Antonella Gagliano

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