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.
    Full-text · Article · Apr 2013 · International clinical psychopharmacology
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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.
    Full-text · Article · Jul 2012 · Journal of Attention Disorders
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    • "With MPH medication, Tower of Hanoi rule-breaking errors decreased , and planning time increased particularly for incorrect solutions (Hazel-Fernandez et al. 2006). MPH also significantly improved performance in the interference score of Stroop color-word task (Langleben et al. 2006). Atomoxetine (ATX) is a new non-stimulant drug for the treatment of ADHD in children and adolescents. "
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    ABSTRACT: This study aimed to compare the effects of osmotic release oral system-methylphenidate (OROS-MPH) and atomoxetine (ATX) on executive function in children and adolescents with attention deficit hyperactivity disorder (ADHD) by a randomized controlled trial. Subjects who met DSM-IV ADHD criteria were randomized to receive either OROS-MPH or ATX treatment. The doses were titrated to achieve optimal response and then maintained for 4-6 wk. A battery of executive function tests and the Behavior Rating Inventory of Executive Function (BRIEF) were administered to subjects who completed the dose titration (OROS-MPH, n=85; ATX, n=57) at the pre- and post-treatment periods. Forty-six children without ADHD were recruited as controls. Both OROS-MPH and ATX significantly improved scores in the Rey Complex Figure Test (RCFT), digit span, and Stroop color-word task. The scores in RCFT and the reverse digit span were not significantly different from the control group at post-treatment assessment (OROS-MPH=ATX=control, p>0.05), whereas the word interference time of the Stroop test was still more than that of the control group (OROS-MPH=ATX>control, p>0.05). OROS-MPH also significantly improved the total correct response in the verbal fluency test to normal level, and the shifting time in the trail-making test to subnormal level. The current findings suggest both OROS-MPH and ATX improved executive function generally in children and adolescents with ADHD, and could return working memory back to normative performance level.
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