• Abstract

    Attention Deficit Hyperactivity Disorder - A.D.H.D. is a pediatric illness that involves psychiatric and neurodevelopmental aspects of the child. It pertains to ‘not so normal’, ‘irritating’ behavior as often labeled by society, not knowing how much it affects the child himself/herself. Three broad types of A.D.H.D. –

    • Inattentive and distractible type
    • Impulsive or hyperactive type
    • Combined form

    All these different types pertain to different manifestations and thus different treatment directives. The following treatment regimens are available:

    1. Medical/pharmacological treatments include stimulants and nonstimulant It is the usual preferred mode of treatment but often has various side effects, such as cardiovascular derangements and seizures.
    2. Psychosocial treatment includes integrated behavioral, mental and social rectification of the child and the symptoms. This approach requires well-trained staff, which limits its effectiveness.
    3. Neurofeedback mechanisms include amplifying signals to strengthen the child’s focus.
    4. Trigeminal nerve stimulators include applying a stimulant over the ophthalmic branch of the trigeminal nerve that stimulates it and thus further alters brain activity.

    EndeavorRx – a prescription-based video game approved by the US FDA to ameliorate the cognition, work memory, integration, attention span and problem-solving ability of the child. It has algorithms and interfaces that customize to the user’s needs and modify the tasks accordingly. It also regulates the emotions of the child. There are positive reviews regarding the game, as it not only puts a band-aid on the pathophysiology but also strengthens the connections to improve it. Additionally, the future is characterized by digitalization; therefore, these would be the more sought options.

     

  • References

    1. Jiang H, Natarajan R, Shuy YK, Rong L, Zhang MW, Vallabhajosyula R. The Use of Mobile Games in the Management of Patients With Attention Deficit Hyperactive Disorder: A Scoping Review. Front Psychiatry. 2022;13:792402.
    2. Magnus W, Nazir S, Anilkumar AC, Shaban K. Attention Deficit Hyperactivity Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 May 8]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK441838/
    3. Attention-Deficit / Hyperactivity Disorder (A.D.H.D.) in Children [Internet]. [cited 2022 May 8]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/A.D.H.D.add
    4. A.D.H.D.: Symptoms, Types, Testing, and Treatment [Internet]. [cited 2022 May 8]. Available from: https://www.webmd.com/add-A.D.H.D./childhood-A.D.H.D./attention-deficit-hyperactivity-disorder-A.D.H.D.
    5. Millichap JG. Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics. 2008 Feb;121(2):e358-365.
    6. Wilens TE, Spencer TJ. Understanding Attention-Deficit/Hyperactivity Disorder From Childhood to Adulthood. Postgrad Med. 2010 Sep;122(5):97–109.
    7. Pandian GSB, Jain A, Raza Q, Sahu KK. Digital health interventions (DHI) for the treatment of attention deficit hyperactivity disorder (A.D.H.D.) in children - a comparative review of literature among various treatment and DHI. Psychiatry Res. 2021 Mar;297:113742.
    8. Thapar A, Cooper M. Attention deficit hyperactivity disorder. The Lancet. 2016 Mar 19;387(10024):1240–50.
    9. Camp A, Pastrano A, Gomez V, Stephenson K, Delatte W, Perez B, et al. Understanding A.D.H.D.: Toward an Innovative Therapeutic Intervention. Bioengineering. 2021 May 1;8(5):56.
    10. Kappel DB, Schuch JB, Rovaris DL, da Silva BS, Müller D, Breda V, et al. ADGRL3 rs6551665 as a Common Vulnerability Factor Underlying Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder. Neuromolecular Med. 2019 Mar;21(1):60–7.
    11. Guan Lim C, Lim-Ashworth NSJ, Fung DSS. Updates in technology-based interventions for attention deficit hyperactivity disorder. Curr Opin Psychiatry. 2020 Nov;33(6):577–85.
    12. Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ. Adult A.D.H.D. and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017 Aug 22;17:302.
    13. Catalá-López F, Hutton B, Núñez-Beltrán A, Page MJ, Ridao M, Saint-Gerons DM, et al. The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review with network meta-analyses of randomised trials. PLOS ONE. 2017 Jul 12;12(7):e0180355.
    14. Brikell I, Chen Q, Kuja-Halkola R, D’Onofrio BM, Wiggs KK, Lichtenstein P, et al. Medication treatment for attention-deficit/hyperactivity disorder and the risk of acute seizures in individuals with epilepsy. Epilepsia. 2019 Feb;60(2):284–93.
    15. Fosi T, Lax-Pericall MT, Scott RC, Neville BG, Aylett SE. Methylphenidate treatment of attention deficit hyperactivity disorder in young people with learning disability and difficult-to-treat epilepsy: Evidence of clinical benefit. Epilepsia. 2013 Dec;54(12):2071–81.
    16. Kollins SH, DeLoss DJ, Cañadas E, Lutz J, Findling RL, Keefe RSE, et al. A novel digital intervention for actively reducing severity of paediatric A.D.H.D. (STARS-A.D.H.D.): a randomised controlled trial. Lancet Digit Health. 2020 Apr;2(4):e168–78.
    17. Rubia K, Criaud M, Wulff M, Alegria A, Brinson H, Barker G, et al. Functional connectivity changes associated with fMRI neurofeedback of right inferior frontal cortex in adolescents with A.D.H.D.. Neuroimage. 2019 Mar;188:43–58.
    18. Stuyver T, Danovich D, Joy J, Shaik S. External electric field effects on chemical structure and reactivity. WIREs Comput Mol Sci. 2020;10(2):e1438.
    19. Managing attention deficit disorder by training the brain [Internet]. EurekAlert! [cited 2022 May 9]. Available from: https://www.eurekalert.org/news-releases/475171
    20. Loo SK, Salgari GC, Ellis A, Cowen J, Dillon A, McGough JJ. Trigeminal Nerve Stimulation for Attention-Deficit/Hyperactivity Disorder: Cognitive and Electroencephalographic Predictors of Treatment Response. J Am Acad Child Adolesc Psychiatry. 2021 Jul;60(7):856-864.e1.
    21. Wong HC, Zaman R. Neurostimulation in Treating A.D.H.D.. Psychiatr Danub. 2019 Sep;31(Suppl 3):265–75.
    22. Cook IA, Espinoza R, Leuchter AF. Neuromodulation for depression: invasive and noninvasive (deep brain stimulation, transcranial magnetic stimulation, trigeminal nerve stimulation). Neurosurg Clin N Am. 2014 Jan;25(1):103–16.
    23. Cai W, Griffiths K, Korgaonkar MS, Williams LM, Menon V. Inhibition-related modulation of salience and frontoparietal networks predicts cognitive control ability and inattention symptoms in children with A.D.H.D.. Mol Psychiatry. 2021 Aug;26(8):4016–25.
    24. Bos DJ, Oranje B, Achterberg M, Vlaskamp C, Ambrosino S, de Reus MA, et al. Structural and functional connectivity in children and adolescents with and without attention deficit/hyperactivity disorder. J Child Psychol Psychiatry. 2017 Jul;58(7):810–8.
    25. Commissioner O of the. FDA Permits Marketing of First Game-Based Digital Therapeutic to Improve Attention Function in Children with A.D.H.D. [Internet]. FDA. FDA; 2020 [cited 2022 May 9]. Available from: https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-first-game-based-digital-therapeutic-improve-attention-function-children-A.D.H.D.
    26. Akili Announces Publication of AKL-T01 A.D.H.D. Pivotal Study Results in the Lancet Digital Health [Internet]. Akili Interactive. [cited 2022 May 10]. Available from: https://www.akiliinteractive.com/news-collection/akili-announces-publication-of-akl-t01-A.D.H.D.-pivotal-study-results-in-the-lancet-digital-health
    27. Akili Interactive Labs, Inc. A Study to Assess Midline Frontal Theta (MFT) Power as Measured by Stimulus-locked Electroencephalography (EEG) Before and After AKL-T01 Treatment for Improving Attention in Pediatric Participants Ages 8-12 Years Old With Attention Deficit Hyperactivity Disorder (A.D.H.D.) [Internet]. clinicaltrials.gov; 2019 Sep [cited 2022 May 8]. Report No.: NCT03844269. Available from: https://clinicaltrials.gov/ct2/show/NCT03844269
    28. Kollins SH, Childress A, Heusser AC, Lutz J. Effectiveness of a digital therapeutic as adjunct to treatment with medication in pediatric A.D.H.D.. NPJ Digit Med. 2021 Mar 26;4(1):58.
    29. A.D.H.D. Treatment For Kids | Digital Therapeutic Video Game for A.D.H.D. [Internet]. EndeavorRx. [cited 2022 May 9]. Available from: https://www.endeavorrx.com/treatment/
    30. Doctors may prescribe this mobile game as a therapy for kids with A.D.H.D.. The Times of India [Internet]. 2020 Jun 16 [cited 2022 May 9]; Available from: https://timesofindia.indiatimes.com/gadgets-news/doctors-may-prescribe-this-mobile-game-as-a-therapy-for-kids-with-A.D.H.D./articleshow/76399403.cms
    31. The story behind an FDA-Approved Video Game Treatment for A.D.H.D. [Internet]. The Medicine Maker. [cited 2022 May 10]. Available from: https://themedicinemaker.com/discovery-development/the-story-behind-an-fda-approved-video-game-treatment-for-A.D.H.D.
    32. de Oliveira Rosa V, Rosa Franco A, Abrahão Salum Júnior G, Moreira-Maia CR, Wagner F, Simioni A, et al. Effects of computerized cognitive training as add-on treatment to stimulants in A.D.H.D.: a pilot fMRI study. Brain Imaging Behav. 2020 Oct;14(5):1933–44.
    33. Jurigova BG, Gerdes MR, Anguera JA, Marco EJ. Sustained benefits of cognitive training in children with inattention, three-year follow-up. PLoS ONE. 2021 Feb 4;16(2):e0246449.
    34. What Is EndeavorRx, and Does A.D.H.D. Video Game Treatment Work? [Internet]. GoodRx. [cited 2022 May 10]. Available from: https://www.goodrx.com/conditions/A.D.H.D./does-endeavorrx-A.D.H.D.-treatment-gamification-work

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright (c) 2024 Multidisciplinary Reviews

How to cite

CHANNAWAR, R., & Chakole, S. (2024). Digital treatment modalities for attention deficit hyperactivity disorder: A review. Multidisciplinary Reviews, (| Accepted Articles). Retrieved from https://malque.pub/ojs/index.php/mr/article/view/3091
  • Article viewed - 2