Langleben DD, Monterosso J, Elman I, Ash B, Krikorian G, Austin G. Effect of methylphenidate on Stroop Color-Word task performance in children with attention deficit hyperactivity disorder. Psychiatry Res 141: 315-320

Harvard University, Cambridge, Massachusetts, United States
Psychiatry Research (Impact Factor: 2.47). 04/2006; 141(3):315-20. DOI: 10.1016/j.psychres.2005.09.007
Source: PubMed


Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric syndrome common in the pediatric population. It is associated with multiple nonspecific deficits on neuropsychological tests of executive function, and a beneficial response to pharmacotherapy with methylphenidate (MPH) and other psychostimulants. The Stroop Color-Word task is used empirically as an aid in diagnosis and treatment monitoring of ADHD; however, data on the sensitivity of the Stroop interference score to the effects of MPH are limited. To address this issue, we studied Stroop performance in a cohort of 18 MPH-treated prepubescent boys with ADHD and six healthy controls on and off MPH treatment conditions. MPH significantly improved performance in both groups, with the ADHD participants consistently displaying worse scores than those of controls both on and off MPH. These results suggest that though the diagnostic value of the Stroop task in ADHD remains controversial, it has heuristic value for monitoring clinical responses to MPH treatment. More research is needed to ascertain the clinical significance of our findings and to replicate this relatively small effect in a larger cohort, to determine whether MPH effects on Stroop performance are specific to ADHD symptoms or they generalize to other forms of symptomatology.

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    • "Most previous studies showed no significant association between interference scores and methylphenidate treatment (Bedard et al., 2002; Scheres et al., 2003; Solanto et al., 2009; Van der Oord et al., 2012). Only one study with a small sample size suggested that interference controls were improved by methylphenidate treatment (Langleben et al., 2006). It is interesting that the commission errors in the ADS were significantly improved, whereas the interference scores in the Stroop Test were not altered. "
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    ABSTRACT: We evaluated the effect of osmotic-release oral system (OROS) methylphenidate on learning skills in adolescents with attention-deficit/hyperactivity disorder (ADHD). In an open-label study, 121 adolescents with ADHD were administered flexible doses of OROS methylphenidate for 12 weeks. The efficacy of methylphenidate on ADHD symptoms was evaluated by ADHD Rating Scale (ARS) and Clinical Global Impression Scale (CGI). Learning Skills Test (LST) was used to measure the learning skills of the participants at the baseline and the endpoint. Continuous performance test, visuospatial and verbal working memory, verbal fluency, and inhibition were evaluated before and after the 12 weeks of treatment. The mean total and subscores of LST were significantly increased after the 12-week treatment with OROS methylphenidate. Executive functions were also improved during the trial, with the exception of inhibition measured by the Stroop Test. To the best of our knowledge, this is the first study to examine the influence of OROS methylphenidate on learning skill. As a result, OROS methylphenidate was effective in enhancing learning skills in adolescents with ADHD.
    International clinical psychopharmacology 04/2013; 28(4). DOI:10.1097/YIC.0b013e3283612509 · 2.46 Impact Factor
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    • "The latency for completion of the TMT controlling for psychomotor processing (TMT B-A) has been shown to be longer in ADHD participants compared with controls (Oades & Christiansen, 2008). The Stroop task and CPT performances have been associated with ADHD diagnosis (Sergeant, Geurts, & Oosterlaan, 2002) and methylphenidate response (Epstein et al., 2006; Langleben et al., 2006). Treatment response measured in terms of ADHD-RS response rate (ADHD-RS total score at baseline − ADHD-RS score at end point)/ADHD-RS total score at baseline was assessed when optimal adjustment of methylphenidate dosage was achieved (no further clinical improvement or limiting side effects). "
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    ABSTRACT: Objective: The Child Behavior Checklist-Dysregulation Profile (CBCL-DP), characterized by elevated scores on the "Attention Problems," "Aggressive Behavior," and "Anxious/Depressed" scales in the CBCL, has been associated with later severe psychopathology. In a sample of children with ADHD, this study sought to further explore the clinical characteristics, the response to methylphenidate medication, and the cognitive features of ADHD children with CBCL-DP. Method: The sample consisted of 173 ADHD outpatients (age = 10.9 ± 2.81) assessed using symptom severity scales, personality questionnaires (Emotionality Activity Sociability [EAS] and Junior Temperament and Character Inventory [JTCI]), and neuropsychological tests. A subsample of 136 participants was reassessed after optimal adjustment of methylphenidate dosage. Results and conclusion: Variables that were independently associated with CBCL-DP were clinical severity (ADHD Rating Scale [ADHD-RS]), internalized disorders, high emotionality (EAS), and low self-directedness (JTCI). CBCL-DP was associated neither with poorer response to methylphenidate nor with more side effects. There were no differences in cognitive performances between participants with and without CBCL-DP.
    Journal of Attention Disorders 07/2012; 19(1). DOI:10.1177/1087054712452135 · 3.78 Impact Factor
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    • "A recent review found approximately 66% of studies showed positive cognitive-MPH effects, with improvement in attention, visual tracking, planning, cognitive flexibility , vigilance, inhibition, and memory/working memory noted (Pietrzak, Mollica, Maruff, & Snyder, 2006). Positive MPH effects on sustained attention, visual-spatial working memory, interference control, and response inhibition have also been reported (e.g., Bedard et al., 2004; Hood et al., 2005; Langleben et al., 2006; McInnes, Bedard, Hogg-Johnson, & Tannock, 2007; Tamm & Carlson, 2007; Wilson et al., 2006), with reductions in impulsivity cited as the possible source of positive MPH treatment effects (e.g., Huang, Chao, Wu, Chen, & Chen, 2007). Such a finding would be consistent with Barkley's (1997) ADHD theory, which argues that response inhibition is a core deficit in ADHD. "
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    ABSTRACT: Methylphenidate (MPH) often ameliorates attention-deficit/hyperactivity disorder (ADHD) behavioral dysfunction according to indirect informant reports and rating scales. The standard of care behavioral MPH titration approach seldom includes direct neuropsychological or academic assessment data to determine treatment efficacy. Documenting "cool" executive-working memory (EWM) and "hot" self-regulation (SR) neuropsychological impairments could aid in differential diagnosis of ADHD subtypes and determining cognitive and academic MPH response. In this study, children aged 6 to 16 with ADHD inattentive type (IT; n = 19) and combined type (n = 33)/hyperactive-impulsive type (n = 4) (CT) participated in double-blind placebo-controlled MPH trials with baseline and randomized placebo, low MPH dose, and high MPH dose conditions. EWM/ SR measures and behavior ratings/classroom observations were rank ordered separately across conditions, with nonparametric randomization tests conducted to determine individual MPH response. Participants were subsequently grouped according to their level of cool EWM and hot SR circuit dysfunction. Robust cognitive and behavioral MPH response was achieved for children with significant baseline EWM/SR impairment, yet response was poor for those with adequate EWM/ SR baseline performance. Even for strong MPH responders, the best dose for neuropsychological functioning was typically lower than the best dose for behavior. Findings offer one possible explanation for why long-term academic MPH treatment gains in ADHD have not been realized. Implications for academic achievement and medication titration practices for children with behaviorally diagnosed ADHD will be discussed.
    Journal of Learning Disabilities 03/2011; 44(2):196-212. DOI:10.1177/0022219410391191 · 1.90 Impact Factor
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